Mechanism matters: A 10-year experience of ballistic injuries of the upper extremity

•Violent and self-inflicted injuries occur in dissimilar populations and result in distinctive patterns of injury.•Violently inflicted UE GSWs occur in young, black men; self-inflicted gunshot wounds more often occur in older, comorbid, Caucasian men.•Violent injuries exhibit a bimodal distribution at the shoulder/arm level and again at the hand level.•Accidental, self-inflicted GSWs most often occur distally at the hand or wrist.•There is a trend that more distal injuries of the hand and wrist, particularly bony injuries, are more likely to require operative management.