Successful treatment of a delayed presentation of a gunshot injury to the femoral neck in an elderly man: a case report.

Ho, Cheng-Jung; Hung, Shao-Hung; Huang, Hsuan-Ti; Huang, Peng-Ju; Lin, Sung-Yen; Fu, Yin-Chih; Chen, Jian-Chih; Cheng, Yuh-Min et al. · Eur J Orthop Surg Traumatol · 2012

case_report · Level V

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Abstract

Gunshot wounds involving major joints can be lethal as a result of the disruption to major neurovascular tracts. We report on a high-energy ballistic injury resulting in a comminuted femoral neck fracture in an elderly patient with a surgical delay exceeding 20 h. The patient underwent bipolar hemiarthroplasty and led a functional, satisfactory life after surgery. Lead intoxication was also identified, and the blood lead concentration was almost two times the positive diagnostic value (25 μg/dL). The rebound in lead concentration suggested delayed lead toxicity. The patient did not have symptoms of plumbism at the last follow-up 4 years after the injury.

Anatomy