Wrist and Forearm Fractures from Ballistic Injuries.

Hand Clin · Aug 2025 · Review

Lin JS, Rhee PC

Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic

Hand & Upper Extremity Orthopaedic Trauma

SUMMARY — THE REDUCTIONThis review discusses evaluation and management principles for ballistic wrist and forearm fractures, emphasizing neurovascular assessment, compartment syndrome risk, contamination-guided debridement/antibiotics, and individualized fracture fixation strategies.
Abstract, as published

Ballistic fractures of the wrist and forearm warrant special consideration due to the proximity of neurovascular structures. Each case requires a thorough assessment for concomitant peripheral nerve and vascular injury as well as the presence of possible development of compartment syndrome, which may be difficult to detect in the setting of the multiply injured patient. The extent of bony and soft tissue injury with the degree of contamination present should be factored into decisions regarding antibiotic treatment and surgical debridement, and the strategy for fracture stabilization and management of osseous defects should be tailored to the individual.

Featured in the 2026-08-13 issue.

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