Self-Inflicted Gunshot Wound to the Hand in Partner Forces – Part 2

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Intra operative

  • Incise and drain entrance and exit wounds
  • Open carpal tunnel release
  • Intact median nerve
  • Intact extensor tendons, < 50% damage to flexor digitorum superficialis and flexor digitorum profundus
  • Intact deep and superficial palmar arch
  • Comminuted third metacarpal and capitate fracture, non-displaced fourth metacarpal base fracture
  • Surgical incisions closed loosely, entrance/exit wounds left open

 Post operative

fig 3

If you could not guarantee continuity of care (must pass care to a lower standard), what instructions would you give to the accepting physician and the patient?

Are there any cultural/military discipline implications for this injury?

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