ReviewEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Ballistic peripheral nerve injuries: basic concepts, controversies, and proposal for a management strategy.
Review in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- The optimal timing of surgical intervention for peripheral nerve injuries from gunshot wounds: A case series and systematic review.Neurosurgical review · 2026Pooled it
- Observation of the therapeutic effect and analysis of risk factors in the acute repair of traumatic digital nerve injury.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- A "Common Sense" Surgical Approach to Motor Shoulder Dysfunction Diagnosed as CRPS I/II Following Projectile Injuries to the Regio Deltoidea in the Late Stages of Ballistic Trauma.Journal of brachial plexus and peripheral nerve injury · 2026Article
- Comparative surgical outcomes in ballistic peripheral nerve injuries: A single-surgeon experience and mechanism-based classification of gunshot versus shrapnel trauma.Brain & spine · 2026Review
- Analysis of Penetrating Injuries to the Sciatic Nerve, Highlighting Insights From Sudan.Plastic and reconstructive surgery. Global open · 2025Article
- "Natural history of low velocity ballistic nerve injuries to the humerus".Archives of orthopaedic and trauma surgery · 2025Article
- Contribution of ultrasound in the management of ballistic nerve injury during the 2020 Nagorno-Karabakh war.Journal of ultrasound · 2025Article
- Extracellular Vesicles in Peripheral Nerve Regeneration: From Biology to Therapeutic Engineering.International journal of nanomedicine · 2025Review
- Ballistic Nerve Injuries: State of the Evidence and Approach to the Patient Based on Experience.Journal of hand surgery global online · 2024Review
- Challenges and solutions for reconstruction of combat extremity injuries encountered during high-intensity warfare.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Treatment of Brachial Plexus Injuries following Gunshot Injuries: A Systematic Review.Advances in orthopedics · 2024Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ballistic injuries to peripheral nerves are devastating injuries frequently encountered in modern conflicts and civilian trauma centers. Such injuries often produce lifelong morbidity, mainly in the form of function loss and chronic pain. However, their surgical management still poses significant challenges concerning indication, timing, and type of repair, particularly when they are part of high-energy multi-tissue injuries. To help trauma surgeons, this article first presents basic ballistic concepts explaining different types of missile nerve lesions, described using the Sunderland classification, as well as their usual associated injuries. Current controversies regarding their surgical management are then described, including nerve exploration timing and neurolysis's relevance as a treatment option. Finally, based on anecdotal evidence and a literature review, a standardized management strategy for ballistic nerve injuries is proposed. This article emphasizes the importance of early nerve exploration and provides a detailed method for making a diagnosis in both acute and sub-acute periods. Direct suturing with joint flexion is strongly recommended for sciatic nerve defects and any nerve defect of limited size. Conversely, large defects require conventional nerve grafting, and proximal injuries may require nerve transfers, especially at the brachial plexus level. Additionally, combined or early secondary tendon transfers are helpful in certain injuries. Finally, ideal timing for nerve repair is proposed, based on the defect length, associated injuries, and risk of infection, which correlate intimately to the projectile velocity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.