[Treatment strategy in explosion and gunshot injuries of the upper extremity]

Explosion and gunshot injuries represent a challenging problem with regard to preserve optimal hand function. These wounds exhibit a spectrum of complexity and mostly include extensive soft tissue trauma complicated by burns, foreign bodies, fractures and concomitant trauma. To gain maximal restoration of hand function the use of microsurgical technique, grafting of nerves, vessels and soft tissue as an acute free flap to cover a large defect immediately is necessary. The experience in treatment of 38 cases of blast and gunshot injuries of the hand are reported. The results are discussed in relation to literature, complication, indication and technique.