The price of peace: the personal and financial cost of paramilitary punishments in Northern Ireland.

The aim of this study was to compare the injuries sustained during paramilitary punishments both before and after the onset of "peace" in Northern Ireland. A retrospective chart review was performed looking at age, injuries, treatments instituted, theatre time, length of hospital stay and overall cost of care. In the 10-month period before the ceasefire, 31 patients were treated after sustaining paramilitary punishment shootings. Mean age was 25.2 years. All patients had small entrance and exit wounds with minimal soft tissue disruption. A total of 18 fractures were recorded in 15 patients and 14 arteries required repair. Mean operative time was 2.6 h, mean hospital stay 7.61 days and mean cost per patient 3102 Pounds. In the following 10-month period 28 patients were admitted after punishments, only one of whom had been shot, all others had been beaten with sticks and clubs. Mean age was 27.4 years. In 52 limbs, 64 fractures were recorded and 44% of these were open; 15 of the fractures were Gustilo and Anderson Grade III or greater and 11 of the fractures were intra-articular. There were no arterial injuries. Mean operative time was 2.6 h, mean hospital stay 12.4 h and mean cost per patient 3849 Pounds.