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The result of a gun shot at close range!

The result of a gunshot at close range! This patient was lucky to get significant reconstructive surgery and repair later.

Only the middle phalanx was lost!

Depending on the severity of the wound, appropriate measurements should be taken in the emergency department. The anatomy of the hand involves so many structures that an injury to an area may result in varying degrees of damage to different parts. The common hand injuries due to a gunshot are fractures on bones of the hand and fingers (the carpal bones, metacarpals, and phalanges), bone loss and instability, soft tissue injuries to the muscles, tendon and ligament injuries and damage to the nerve and blood vessels.

Following a limited debridement (removing dead tissue from the wound), the fractures are managed with early fracture stabilization, internal/external fixation, reduction and splinting. Follow-up surgeries are indicated depending on the extent and severity of the injury. Bone grafting is used in some cases, while in others amputation of digits or damaged parts may be required.

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