Low-Velocity Gunshot Wounds of the Hand

We reviewed 32 low-velocity gunshot wounds of the hand to determine the residual impairment of the finger and hand. Spontaneous return of function occurred in nine of ten nerve injuries with partial permanent loss in one. The severity of loss of finger function was primarily related to the location of fractures. Fractures involving the proximal interphalangeal joint produced the greatest impairment, followed by fractures of the proximal phalanx and then the metacarpals. Unstable fractures resulted in more restriction of motion than stable fractures. Internal fixation of unstable fractures may permit earlier motion and a better result. All patients were able to carry out daily, self-care activities in spite of occasionally severe restriction of motion in a single finger.