Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Hip
Abstract number: 25699
FIREARM FEMORAL HEAD OPEN FRACTURES
Jaime LOPEZ 1 , Dante PARODI 2 , Alvaro NUñEZ 2 , Joaquin LARA 1 , Claudio MELLA 2 ,
Luis MOYA 1
1 clinica Alemana de Santiago, santiago (CHILE), 2 Clinica Alemana de Santiago,
Santiago (CHILE)
The management of femoral head fractures firearm show controversial literature
regarding approaches. Treatment includes surgical debridement, bone stabilization
and removal of the projectile.The aim is to present our experience in the
management of open fractures of femoral head by a firearm.We presented three
male cases. 26 years old patient with abdominal wall projectile injury without exit.
The bullet was founded in the femoral head through the acetabular medial wall.
Second case an 18 years old with gunshot wound in the trochanteric region ending in
the femoral head. Last case an 18 years old presenting entrance wound in the
anterior hip region impacted in the anterior wall and labrum. None lesion of large
vessels or neurological injury was founded. In the first two cases was performed a
surgical hip dislocation retiring the bullet, adding in the second case prophylactic
cannulated screws in femoral neck. The third case required an anterior hip approach
(Hueter), removal of bullet and prophylactic cannulated screws in femoral neck.We
founded no infection, AVN or osteoarthritis. No lead poisoning. The patients with
surgical dislocation healed at a mean of 3 months. We recognized it´s a small series
and have a short to medium term monitoring, but has shown that early and
aggressive treatment of these high energy injuries with surgical debridement and
removal of the projectile by surgical dislocation and anterior hip approach allows the
right solution without adding morbidity or increasing the risk of the femoral head
blood supply.
563