This study aimed to quantify rates of nerve involvement, management strategies, and return of functional impairment in patients with civilian extremity gunshot wounds. We performed a retrospective review of 34 patients presenting with extremity gunshot wounds with nerve injury to our level 1 trauma center between January 2019 and October 2021. The incidence of nerve involvement and functional deficits after extremity GSW and rate of return of function after operative or non-operative management were reported. Nerve involvement was found in 34 (34聽%) patients in the cohort with 23 (68聽%) involving the upper extremities and 11 (32聽%) involving lower extremities. Among patients with nerve injuries, 81聽% had concomitant fractures. 59聽% of patients reporting sensory only, 34聽% sensory and motor, and 6聽% motor only deficits. 31聽% of nerve injuries underwent a surgical procedure targeting their nerve injury with the remaining 69聽% managed nonoperatively. Complete resolution of nerve functional deficits in the 29 patients with at least 90 days of follow-up or full return of function was reported in 22聽% and 32聽% of patients who were treated operatively and nonoperatively, respectively (p聽=聽0.62). Nerve injuries were found in approximately one-third of the extremity gunshot wounds at our trauma center. These injuries carried poor prognosis with low recovery rate with either operative or non-non operative treatment.
