Epidemiology of Ballistic Upper Extremity Injuries: Identifying Factors and Future Strategies

Hand Clin. 2025 Aug;41(3):281-287. doi: 10.1016/j.hcl.2025.03.003. Epub 2025 Apr 30.

Abstract

Ballistic injuries of the upper extremity account for a considerable portion of ballistic injuries, resulting in morbidity for the patient and high healthcare costs. Patients sustaining ballistic injuries have a wide range of features and injury patterns. Frontline providers and institutional policy makers can help decrease the morbidity and socioeconomic burden linked with the injuries by better categorizing these injuries. In this paper, we discuss epidemiological factors discussed in the literature and summarize the common factors identified in previous epidemiological studies. Males, individuals in their early decades of adult life, Black individuals, those in Southern United State regions, socioeconomic disadvantaged regions are more commonly affected. Proximal injuries of the upper extremity were more common in the ballistic trauma setting with the bone and nerves injured more than other structures. Robust, more comprehensive data are needed to further define the epidemiology of upper extremity ballistic injuries. Such data can be used to guide structured patient education, precision medicine initiatives, and the development of policy aimed at reducing the morbidity caused by ballistics.

Keywords: Ballistic injuries; Epidemiology; Hand surgery ballistic injuries; Public health.

Publication types

  • Review

MeSH terms

  • Arm Injuries* / epidemiology
  • Female
  • Humans
  • Male
  • Risk Factors
  • United States / epidemiology
  • Upper Extremity* / injuries
  • Wounds, Gunshot* / epidemiology