12. Injury Patterns and Treatment of Gunshot Wounds to the Hand: Experience from an Urban Level 1 Trauma Center

OBJECTIVE: Gunshot Wounds of the Hand (GSH) require specialized care to restore form and function. Often, these resources are scarce and are needed after hours leading to delay or alterations in care. Our study aimed to study the volume, injury patterns and timing of surgery in GSH at a major urban trauma center. METHODS: Data was abstracted from our Trauma Registry from January 1, 2018 to December 31, 2022. Demographic data of age, sex and race, injury patterns of bone, tendon, vascular, nerve and soft tissue injury and operative or non-operative care were studied. Regular working hours cases started between 7.00 AM to 6.00 PM. After hour surgeries were cases starting after 6.00 PM and on weekends. RESULTS: There were a total of 130 GSH. Patients were mostly male 116 (90%) and African American 118 (91%). 73 patients (56%) had other associated injuries. The injury patterns were soft tissue 122 (94%), bone 77 (59%), tendon 42 (32%), nerve 22 (17%), and vascular 13 (10%). 67 (51%) patients underwent an operation in the operating room. Of the operations done, 40 (60%) were done after hours which was not significant. Of the tendon injuries, 70.7% of the operations were done afterhours (p<.05). CONCLUSION: A majority of GSH needed operative intervention by a fellowship trained surgeon. Most operations happened after hours or on weekends. This study helps to define injury and operative patterns of GSH, to better understand the specialized care and after hours resource needs associated with these injuries. CORRESPONDING AUTHOR: Tyler Masters, MD, Ascension St John Hospital, Detroit, MI 48236; [email protected]; 248-705-4222