Significant Prevalence of nerve injuries associated with extremity civilian low-energy gunshot wounds with limited recovery of functional deficits

Abstract

This study aimed to quantify rates of nerve involvement, management strategies, and return of functional impairment in patients with civilian extremity gunshot wounds. We performed a retrospective review of 34 patients presenting with extremity gunshot wounds with nerve injury to our level 1 trauma center between January 2019 and October 2021. The incidence of nerve involvement and functional deficits after extremity GSW and rate of return of function after operative or non-operative management were reported. Nerve involvement was found in 34 (34 %) patients in the cohort with 23 (68 %) involving the upper extremities and 11 (32 %) involving lower extremities. Among patients with nerve injuries, 81 % had concomitant fractures. 59 % of patients reporting sensory only, 34 % sensory and motor, and 6 % motor only deficits. 31 % of nerve injuries underwent a surgical procedure targeting their nerve injury with the remaining 69 % managed nonoperatively. Complete resolution of nerve functional deficits in the 29 patients with at least 90 days of follow-up or full return of function was reported in 22 % and 32 % of patients who were treated operatively and nonoperatively, respectively (p = 0.62). Nerve injuries were found in approximately one-third of the extremity gunshot wounds at our trauma center. These injuries carried poor prognosis with low recovery rate with either operative or non-non operative treatment.

Keywords: Extremity gunshot wound; Nerve injury.