1/2. Traumatic fixation of the hip by a bolt fired from a bolt gun.A 25-year-old building worker was struck in the left hip by a 12.7-cm long bolt fired from a bolt gun. The bolt penetrated deeply into the pelvis, through the acetabulum, the joint cavity and the head of the femur leading to fixation of the hip. In spite of immediate extraction of the nail, cleansing, immobilization, antibiotics and tetanus prophylaxis, the wound became infected. The tips of the modern types of nails used in nail guns may be coated with a plastic material which can constitute a troublesome foreign body if left behind, because the nail is merely extracted without opening and exploring the track.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/2. A new technique for removal of intraarticular bullet fragments from the femoral head.Removal of foreign bodies from a joint usually involves an extensive surgical approach. The necessity for intraarticular bullet removal has been well documented in the literature. The conventional approach for bullet extraction usually requires an open arthrotomy, arthroscopic removal or, in most cases, a combination of the two. This report involves a previously undocumented technique for bullet removal from the hip. A Synthes DHS Triple Reamer was inserted through a limited lateral incision over a guide pin that had been placed under fluoroscopic guidance. The tip of the guide pin was positioned in contact against the bullet fragments in both the anteroposterior and lateral planes. The fragments were then removed through the reamed canal. This technique allows for bullet removal without the inherent risks associated with an open arthrotomy and without the special skills required for hip arthroscopy. It is relatively easy to perform and may prove to be a valuable tool in the arsenal of orthopedists who deal with specific gunshot wounds to the hip region.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |