Based on a study of 120 gunshot and fragment wounds of the metacarpus, we conclude that these wounds should be debrided and subjected to delayed closure technics. Even relatively low-velocity missiles may cause serious damage. Metacarpal stabilization with Kirschner wires may be done with impunity to obtain proper alignment, rotation, apposition, and length, in that order of priority. Immediate muscular activity is beneficial. Reconstructive procedures must be individualized to each case and should be considered technically difficult to perform.