Abstract
Gunshot wounds (GSWs) with nerve injuries in the 21st century differ significantly from those reported in the 20th century. The vast majority are now low-velocity civilian injuries, in contrast to high-velocity military injuries previously reported. The rate of nerve injury in civilian GSWs is approximately 5%, compared with the 30% reported in military cohorts. However, the most common pattern of nerve injury in the current civilian population is neurotmesis and partial neurotmesis, in contrast to the majority axonotmesis of the military cohorts. In the 20th century, treatment generally consisted of watchful waiting for signs of spontaneous recovery over three months to six months (axonotmesis) with surgical exploration reserved for patients who failed to show signs of improvement. Late treatment typically consisted of nerve grafts or tendon transfers. Most patients with nerve deficits now benefit from acute repair. New repair techniques have been developed that improve outcomes. The new techniques are reviewed in a companion article by Dr. Mercer in this Journal.
Recommended Citation
DeCoster, Thomas A.. "21st Century Perspective on the Changing Pattern of Nerve Injuries from Gunshot Wounds in the U.S.." Western Journal of Orthopaedics 15, 1 (2026). https://digitalrepository.unm.edu/wjo/vol15/iss1/5