Total hip arthroplasty after hip joint gunshot injury

Abstract

Background: Gunshot injury of the hip joint was reported to constitute 2–17% of all extremity firearm injuries. However, there are few studies in the literature related to gunshot injuries of the hip joint. The aim of the current study was to present the results of 10 cases treated with arthroplasty following a gunshot injury to the hip joint together with the recommended treatment algorithm. Methods: Patients with a previous medical history of hip joint region gunshot injury who underwent total hip arthroplasty were retrospectively evaluated. Those with incomplete medical records or who were lost to follow-up were excluded. Patients were classified according to the severity of the previous gunshot injury to the hip joint region. Harris hip score (HHS) and Short Form-12 quality of life score were the main outcome measurements. Postoperative complications encountered during follow-up were recorded. Results: The mean age of the patients at the time of surgery was 29.9 years. The mean preoperative HHS was 25.2 points and it was 65.8 at the final follow-up. Patients with bullet fragments in the hip joint, classified as group 1, had better HHS, whereas those with contaminated hip joint with intestinal flora, classified as group 3, had worst HHS. Conclusion: Hip arthroplasty after hip joint gunshot injury is a good treatment choice in young patients to reduce pain and regain functions. However, very high infection rates can be seen in patients with accompanying intestinal injury.

Treatment of Secondary Hip Arthritis from Shell Fragment and Gunshot Injury in the Syrian Civil War

“…In a study patients treated with arthroplasty following a gunshot injury to the hip joint, those with contaminated with intestinal ora had worst harris hip score. Very high infection rates were seen in patients with accompanying intestinal injury [5]. In the current study there was only one patient with intestinal injury and infection was not occured after arthroplasty.…”

“…Arthroplasty should be done under elective conditions because of the risk of infection. In the present study, hip arthroplasty was performed in the chronic period after hip joint gunshot and shell fragment injuries as in previous studies [5,9,10]. In patients with posttraumatic arthritis occured after gunshot wounds, surgery is more di cult than primary total hip arthroplasty [9].…”

“…However, the literature has documented some cases of systemic lead intoxication in patients whose bullets are in contact with synovial and cerebrospinal uid [4]. A bullet that passes into the hip joint is rarely cause an infection, but a transabdominal trajectory that subsequently enters the hip joint indicate a high risk for infection after total hip arthroplasty [5].…”

Treatment of Secondary Hip Arthritis from Shell Fragment and Gunshot Injury in the Syrian Civil War

“…If the abductor muscle length is not preserved due to fracture of the femoral neck and displacement of the trochanter, femoral shortening is necessary [10].…”

“…However, the literature has documented some cases of systemic lead intoxication in patients whose bullets are in contact with synovial and cerebrospinal uid [9]. A bullet that passes into the hip joint is rarely cause an infection, but a transabdominal trajectory that subsequently enters the hip joint indicate a high risk for infection after total hip arthroplasty [10].…”