[Gunshot and explosion injuries of the hand]

The problem of hand injuries from bullets and explosives is covered in this paper by the example of three cases. The recommendation is made to remove only easily accessible projectiles. The damage caused by the intervention must not be larger than that caused by the bullet injury. Essential measures should include immediate wound toilet with removal of devitalised tissue, primary osteosynthesis, preferentially with minifixateur externe, coverage of exposed tendons, nerves, bones, and joints, splitting of the ligamentum carpi volare, perioperative administration of antibiotics, and secondary skin suture. Definite treatment should be left to a centre of hand surgery.