Epidemiology of gunshot wounds to the hand

Due to increased gun availability/prevalence in current times, low-velocity firearm injuries have risen dramatically. This study describes the epidemiology of gunshot wounds (GSW) to the hand. We identified all patients (January 2005 - August 2015) who presented to our Level 1 trauma center with GSW's to the hand. Analysis of each record was performed to collect epidemiological variables. Cross-sectional analyses were performed to quantify the results. Following inclusion/exclusion criteria, 97 patients were selected. Individuals who sustained GSW's to the hand were typically male (93.8%) between the ages of 18 and 30 (48.5%). Injuries were mostly self-inflicted (81.4%), and isolated (89.7%) to the digits (55.7%) or metacarpals (35.1%) of the left hand (74.2%). Most were fired from BB/pellet guns (45.4%) or handguns (33.0%), while cleaning/loading them (65.1%). Over one-half of patients (58.8%) were uninsured. Surgery was required in 35.1% of patients. Patients shot with something other than a BB/Pellet gun (e.g., handgun, shotgun) required surgery significantly more than those shot with a BB/Pellet gun (P < 0.0001). An odds ratio further describing this relationship was 0.13 (P = 0.0002), reflecting an 87% reduction in the odds of surgery for individuals shot by a BB/pellet vs. a different type of gun. The typical GSW to the hand involves a middle-aged male receiving an isolated injury to the digits or metacarpals of the left hand, from a BB/Pellet gun or handgun while they are cleaning/loading the firearm. Patients sustaining injury by a BB/pellet gun are least likely to require surgery.