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Gunshot wounds (GSWs) to the distal radius are complex, often affecting younger males and requiring delayed surgery. However, ballistic and nonballistic fractures show similar complication rates.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Hand Surgery

Background:

  • Gunshot wounds (GSWs) to upper extremities pose significant surgical challenges.
  • Distal radius fractures (DRFs) from GSWs require careful management due to potential bony, neurovascular, and soft tissue damage.

Purpose of the Study:

  • To compare demographics, management, and complications of ballistic (GSW) versus nonballistic distal radius fractures.
  • To identify specific challenges associated with GSWs to the distal radius.

Main Methods:

  • Retrospective review of patients (age > 16) with radiographically confirmed DRFs (2018-2023).
  • Data collected included demographics, surgical details, and postoperative complications.
  • 1:1 matched cohort analysis controlling for age, smoking, and fracture classification.

Main Results:

  • GSW patients were younger, predominantly male, with higher comminution, distal radioulnar joint instability, and carpal fractures.
  • GSW patients experienced more extra-upper extremity injuries and neurovascular symptoms, necessitating delayed surgery.
  • Despite delayed intervention, no significant differences in fixation methods, weight-bearing time, or complications were observed between groups.

Conclusions:

  • GSWs to the distal radius present unique demographic and injury patterns compared to nonballistic fractures.
  • While management and surgical timing differ, GSWs to the distal radius do not lead to increased postoperative complications.
  • Hand surgeons must be prepared for the complexities of ballistic distal radius fractures.