Two‐step sequential management for hip arthroplasty after hip joint gunshot injury: A case report

Zandi, Reza; Talebi, Shahin; ehsani, akbar; Nodehi, Saeed

doi:10.1002/ccr3.7569

Cited by 2 publications

References 14 publications

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Intracapsular neck of femur fractures secondary to civilian gunshot injuries: an inter- and intra-observer agreement study on classification and treatment using the AO/OTA classification

Maqungo,

Nicol,

Laubscher

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose Numerous classification systems have been developed for neck of femur fractures, but none have been tested for reliability in gunshot injuries. Our primary objective was to assess the inter-observer and intra-observer reliability of the AO/OTA classification system when applied to intracapsular neck of femur fractures secondary to low-velocity civilian gunshots wounds (GSWs). Our secondary objective was to test the reliability of the AO/OTA classification system in guiding surgeon treatment choices for these fractures. Patients and methods Eighteen reviewers (six orthopaedic traumatologists, six general orthopaedic surgeons and six junior orthopaedic fellows) were given a set of 25 plain radiographs and CT scans of femur neck fractures secondary to GSW. For each clinical case, all reviewers selected a classification as well as treatment option from a list of given options. Inter-observer reliability was measured at the initial classification. The exercise was repeated 10–12 weeks later by the same 18 reviewers to test intra-observer reliability. Results The Fleiss kappa values indicate only slight agreement amongst raters, across all experience levels, for both injury classification and treatment. Intra-observer agreement was fair across all experience levels for both injury classification and treatment. Conclusion The AO/OTA classification showed only slight reliability in classification of gunshot fractures of the femur neck. With only fair reliability, it also failed to guide surgical treatment thus rendering its routine use in daily clinical practice of questionable value.

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Intracapsular neck of femur fractures secondary to civilian gunshot injuries: an inter- and intra-observer agreement study on classification and treatment using the AO/OTA classification

Maqungo,

Nicol,

Laubscher

et al. 2024

Eur J Orthop Surg Traumatol

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Removal of retained bullets from the hip joint in civilian gunshot injuries.

Maqungo,

Nicol,

Kauta

et al. 2024

Preprint

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Purpose Removal of bullets retained within joints is indicated to prevent mechanical blockade, 3rd body wear and resultant arthritis, plus lead arthropathy and rarely, systemic lead poisoning. We aimed to report on the largest series of removal of bullets from the hip joint using open surgical techniques. Methods This is a retrospective cohort study of all patients who presented to a single Level 1 Trauma Unit with civilian gunshot injuries that had breached the hip joint between 01 January 2009 and 31 December 2022. Results: We identified one hundred and seventeen (117) adult patients who met our inclusion criteria. Of these patients 72 had bullets retained within the hip joint area. Forty-six patients underwent bullet removal using the following techniques: hip arthrotomy (n=19), surgical hip dislocation (n=18), direct removal without capsulotomy (tractotomy) (n=5), removal at site of fracture fixation/replacement (n=3), posterior wall osteotomy (n=1). No patients underwent hip arthroscopy. In 26 patients we did not remove bullets for the following reasons: final location was extra-capsular embedded in the soft tissues (n=17), clinical decision to not remove though bullet due to the patients’ clinical condition not allowing for further surgery (n=8) and patient refusal (n=1). Conclusion: With adequate pre-operative imaging and surgical planning, removal of retained bullets from the hip joint can be achieved using open surgical techniques without the need for hip arthroscopy.

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Two‐step sequential management for hip arthroplasty after hip joint gunshot injury: A case report

Cited by 2 publications

References 14 publications

Intracapsular neck of femur fractures secondary to civilian gunshot injuries: an inter- and intra-observer agreement study on classification and treatment using the AO/OTA classification

Intracapsular neck of femur fractures secondary to civilian gunshot injuries: an inter- and intra-observer agreement study on classification and treatment using the AO/OTA classification

Removal of retained bullets from the hip joint in civilian gunshot injuries.

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