Current Evidence in the Management of Ballistic Peripheral Nerve Injuries.

Hand Clin · Aug 2025 · Review

Park KE, Kuo KT, Tuffaha SH

Department of Plastic and Reconstructive Surgery, Johns Hopkins University, 720 Rutland Avenue

Hand & Upper Extremity

SUMMARY — THE REDUCTIONBallistic nerve injuries require individualized management based on nerve continuity; normal-appearing nerves should be treated expectantly rather than routinely repaired.
Abstract, as published

Nerve injuries after ballistic injury can cause devastating consequences to the patient, in part, due to no management guidelines on how to approach and manage these scenarios. While discontinuous nerve lesions after ballistic injury are often less challenging to diagnose and have clearer guidelines for the timing and type of treatment, nerve in-continuity injuries from ballistic wounds are challenging to diagnose and manage. This review on nerve injuries after ballistic wounds covers the etiology, evaluation, and management of these injuries and provides insight on how our institution manages these scenarios. Normal appearing nerves intraoperatively should be treated expectantly.

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