The anatomic complexity of the hand and the proximity of its structures make gunshot injuries especially prone to severe, multi-tissue damage. These injuries often involve multiple structures, including bones, tendons, nerves, and skin, simultaneously, requiring individualized and frequently staged treatment. Various reconstructive strategies are available for each affected structure. In this article, we provide an overview of treatment choices and a representative case that illustrates the clinical reasoning behind selecting among these alternatives in the context of a complex hand gunshot injury, with a focus on restoring function as the primary goal of reconstruction.
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