Gunshot Wounds to The Hip

Sithombo Maqungo; Daniel Fegredo; Milos Brkljac; Maritz Laubscher

doi:10.1016/j.jor.2020.09.018

Gunshot Wounds to The Hip

J Orthop. 2020 Oct 7:22:530-534. doi: 10.1016/j.jor.2020.09.018. eCollection 2020 Nov-Dec.

Authors

Sithombo Maqungo¹, Daniel Fegredo², Milos Brkljac³, Maritz Laubscher¹

Affiliations

¹ Orthopaedic Research Unit, Groote Schuur Hospital, Main Rd, Observatory, Cape Town, 7925, South Africa.
² Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
³ Imperial College Healthcare NHS Trust, Praed St, Paddington, London, W2 1NY, UK.

Abstract

Gunshot wounds to the hip region are likely to cause complex peritrochanteric fracture. The fracture patterns are often highly comminuted and accompanied by injuries to local structures and abdominal viscera. Our case series analyses 25 orthopaedic procedures performed. The overall union rate for primary fixation was 66%. Two patients underwent revision surgery for failed primary fixation. Two cases where fixation had failed were revised to total hip replacement successfully. These types of injuries present a formidable challenge. Preservation of the femoral head should be prioritised to avoid arthroplasty. Long-term follow-up is necessary in assessing the success of these procedures.

Keywords: ATLS, Advanced Trauma Life Support; CT, Computed Tomography; DHS, Dynamic Hip Screw; Femur; GSWs, Gunshot Wounds; Gunshot wounds; Hip; LODOX, Low-dosage, digital X-ray scan; Low-velocity; NOF, Neck of Femur; Neck of femur; THR, Total Hip Replacement; Trauma; USD, United States Dollar.