Wrist and Forearm Fractures from Ballistic Injuries

Ballistic fractures of the wrist and forearm warrant special consideration due to the proximity of neurovascular structures. Each case requires a thorough assessment for concomitant peripheral nerve and vascular injury as well as the presence of possible development of compartment syndrome, which may be difficult to detect in the setting of the multiply injured patient. The extent of bony and soft tissue injury with the degree of contamination present should be factored into decisions regarding antibiotic treatment and surgical debridement, and the strategy for fracture stabilization and management of osseous defects should be tailored to the individual.