A Late Hip Pain after a Gunshot Wound: Treatment by Mini - arthrotomy

Abstract

Foreign body is rarely seen as an etiologic factor of the hip pain. Hip arthroscopy is the first choice as a treatment method on the last years. Mini arthrotomy is an alternative treatment option. 36-year-old man had gunshot wound to his posterior pelvic area six months ago. In the first 4 months he had no symptoms. For the last 2 months, a progressive left hip pain was started especially while he was walking or standing on. There was no pain while sitting. Left hip radiography and pelvic tomography were taken. A bullet fragment was embedded in the central wall of acetabulum caused osteoarthritic changes. A mini arthrotomy was performed by the anterior incision of the hip. Bullet was extracted where it was embedded. Foreign body in the hip joint must not be overruled as an etiologic factor of hip pain. Arthroscopy and mini arthrotomy are the treatment options according to the patients’ position and the surgeon’s skills. In case the treatment was not performed, several complications such as lead synovitis, local chemical and mechanic arthritis as well as systemic plumbism could be seen. Early extraction of the lead bullet from the joint with arthroscopically or anterior mini arthrotomy will prevent against such complications.