Civilian gunshot wounds to the fingers treated with primary bone grafting

Civilian gunshot injuries often consist of relative soft-tissue sparing and minimal contamination. Primary bone grafting with allograft for wounds limited to the digits was used in a one-stage reconstruction enabling bony union with minimal complications in this specific population. All patients suffering from small-calibre gunshot wounds to the hand treated between 2004 and 2006 with a single-stage surgery were reviewed. Surgery consisted of limited debridement and bone grafting of the fracture. Allomatrix was used in all of the patients. There were 12 patients; seven with isolated wounds to a finger. All of the patients had devastating bony injuries. The average follow-up period was 14 weeks. All patients progressed to bony healing. One patient had a second surgery for additional bone grafting. There were no complications. Relatively low contamination allows for primary bone grafting without increasing the risk of infection. This one-step approach to civilian gunshot wounds to the hand has minimal complications and allows for healing, while addressing the problem of non-compliance in this specific population. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.