Gunshot Wounds to the Hip with Associated Sciatic Nerve Injury: Report of Two Cases and Review of the Literature

Abstract

Two cases of intra-articular gunshot wounds to the hip associated with sciatic nerve damage are presented. Both patients had signs of both peroneal and tibial nerve involvement. Plain films revealed bullet fragments close to the femoral neck. Computerized tomography (CT scan) confirmed the intra-articular location of the fragments without associated femoral neck fracture. The patients had surgery for removal of the bullet fragments in the joint and exploration of the sciatic nerve. Post-operatively the neurological deficit persisted in both patients. The patients are currently treated for residual peroneal nerve damage with physiotherapy at eight and six months post injury. A thorough understanding of the management of intra-articular hip gunshot wounds with or without nerve involvement is of vital importance to the orthopedic traumatologist working at an urban level one trauma center. We are reporting two cases and reviewing the controversial existing literature on this complicated problem.

Key words

Missile injuries - intracapsular bullet fragments - lead - neurological damage

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