A and B, Comminuted middle finger metacarpal shaft fracture with intercalary bone loss from self-inflicted handgun injury in 17-year-old boy. C and D, Clinical appearance of hand before debridement. E and F, Surgical debridement of devitalized second and third dorsal interossei and incidental deficit of second web space common digital nerve. G and H, Intramedullary fixation with large Kirschner wire.