Management of Civilian Gunshot Injuries to the Hip
| Autor: | Joseph B. Boucree, Earl W. Brien, William T. Long, Lawrence D. Dorr, Blair C. Filler, Herbert H. Stark |
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| Rok vydání: | 1995 |
| Předmět: |
musculoskeletal diseases
Arthrotomy medicine.medical_specialty business.industry medicine.medical_treatment GUNSHOT INJURY Trauma center Diagnostic evaluation Surgery medicine.anatomical_structure Orthopedic surgery medicine Internal fixation Orthopedics and Sports Medicine Arthrogram business Femoral neck |
| Zdroj: | Orthopedic Clinics of North America. 26:123-131 |
| ISSN: | 0030-5898 |
| DOI: | 10.1016/s0030-5898(20)31974-x |
| Popis: | SUMMARY The orthopedic surgeon at a civilian trauma center is likely to encounter a gunshot injury to the hip. The nonmilitary literature regarding this injury gives few guidelines regarding an appropriate diagnostic evaluation or the indication for arthrotomy. We found that the best diagnostic test to detect joint penetration was hip aspiration followed by an arthrogram. Selected cases can be treated successfully with antibiotic therapy without an arthrotomy. These cases involve a low-velocity missile that passes through the joint, causes minimal bone disruption, and is free of bowel contaminants. If an arthrotomy is not performed, the physician must follow the patient with repeated physical examinations, complete blood counts, and a hip aspiration whenever infection is suspected. All transabdominal hip injuries require an immediate arthrotomy. In this series, bullets left in contact with joint fluid resulted in joint destruction or infection. Each patient with a displaced femoral neck fracture had a poor outcome with internal fixation. Hip arthroplasty or fusion should be considered as elective procedures for definitive management of these injuries. |
| Databáze: | OpenAIRE |
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