Abstract:
BACKGROUND:Although gunshot injuries are relatively common, there is little consensus about whether retained bullets or bullet fragments should be removed routinely or only in selected circumstances. QUESTIONS/PURPOSES:We performed a systematic review of the literature to answer the following questions: (1) Is bullet and/or bullet fragment removal from gunshot injuries to the pelvis or extremities routinely indicated? And, if not, (2) what are the selected indications for removal of bullets and/or bullet fragments? METHODS:A search of the English-language literature on the topic of gunshot injury and bullet removal was performed using the National Library of Medicine and MEDLINE(®) and supplemented by hand searching of bibliographies of included references. Studies were included if they provided clinical data on one or both of our study questions; included studies were evaluated using the levels of evidence rubric. Most studies on the subject were expert opinion (Level V evidence), and these were excluded; one Level III study and seven Level IV studies were included. RESULTS:No studies provided a rationale for routine bullet removal in all cases. The studies identified bullet fragment removal as indicated acutely for those located within a joint, the palm, or the sole. Chronic infection, persistent pain at the bullet site, and lead intoxication were reported as late indications for bullet removal. CONCLUSIONS:The evidence base for making clinical recommendations on the topic of bullet and bullet fragment removal after gunshot injury is weak. Level I and II evidence is needed to determine the indications for bullet removal after gunshot injury.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Riehl JT,Sassoon A,Connolly K,Haidukewych GJ,Koval KJdoi
10.1007/s11999-013-3260-8subject
Has Abstractpub_date
2013-12-01 00:00:00pages
3956-60issue
12eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章,评审abstract:BACKGROUND:Degenerative rotator cuff tears are increasing with the aging population, and healing is not uniform after surgery. Rotator cuffs may show improved healing when biologic factors are added during surgery. QUESTIONS/PURPOSES:We asked: (1) What cellular processes are involved in normal bone-to-tendon healing? ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-010-1323-7
更新日期:2010-06-01 00:00:00
abstract::A multicenter retrospective review was performed analyzing 1081 primary total hip replacements in 944 patients using the Harris Galante-I cementless acetabular component with screw fixation. All patients were followed up for a minimum of 5 years with a mean followup of 81 months. Linear polyethylene wear averaged 0.11...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,多中心研究
doi:10.1097/00003086-199912000-00016
更新日期:1999-12-01 00:00:00
abstract::There are three phases in the treatment of open fractures and infected pseudarthroses by the Hoffmann external fixator. During the initial phase a careful surgical debridement is performed in the bony tissues, and the external fixator is applied in a manner appropriate to the type and level of the lesion site (double-...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. QUESTIONS/PURPOSES:The aims of the stud...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3622-x
更新日期:2015-03-01 00:00:00
abstract::Periprosthetic osteolysis caused by wear debris released from the bearing surface of polyethylene components is the major problem in contemporary hip arthroplasty. Several types of metal on metal prostheses were developed in the 1960s, but by the mid 1970s they were completely displaced by polyethylene bearings. There...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-199608001-00003
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Recent popularity of intramedullary nails over sliding hip screws for treatment of intertrochanteric fractures is concerning given the absence of evidence for clinical superiority for nailing yet the presence of reimbursement differences. QUESTIONS/PURPOSES:We describe the change in outcomes of both procedu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2694-8
更新日期:2013-04-01 00:00:00
abstract::Clinical and cadaveric studies were done to investigate the role of a degenerative fringe of the radiocapitellar complex subluxating in the radiocapitellar joint in patients with lateral epicondylitis. In the clinical study, arthroscopic resection of this capsular complex was done. Thirty patients with recalcitrant sy...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000176143.08886.fe
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Reverse shoulder arthroplasty has been proven to improve function in shoulders with cuff-tear arthropathy, but existing studies are primarily single-center studies with a small number of patients, which limits their ability to identify patients who have an increased risk of revision or a worse functional out...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000001114
更新日期:2020-05-01 00:00:00
abstract::A ball-and-socket joint is an unusual disturbance of normal ankle development. Previous reports have noted good function and the absence of osteoarthritic change in ankles with this configuration. A 50-year-old man with no history of injury developed an osteoarthritic ball-and-socket deformity of the ankle joint. Asso...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
abstract::Mineral-matrix interactions regulate the process of hydroxyapatite formation in bones and teeth. In mineralizing tissues, many anionic macromolecules bind to mineral. By means of this binding, such molecules are able to regulate the size and shape of the mineral crystals, determine the site of initial crystal depositi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Since 1941, distal clavicle excision has been a reliable technique for alleviating pain caused by acromioclavicular joint arthritis. Disadvantages of the procedure include permanent shoulder weakness, a lengthy recovery time ranging from weeks to months before useful function of the extremity returns, and lack of cosm...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::Health care costs for inpatient care have been escalating. Homeless and indigent patients may be unable to have access to clean toilet facilities to perform adequate wound care. Evaluation of delayed primary closure of upper extremity soft tissue infections after incision and drainage in 34 patients was done. Patients...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::In 20 dogs olecranon osteotomies fixed with tension band wires were studied histologically to reveal the pattern of healing. Different degrees of stability existed in different areas of the osteotomy. Under stable conditions cancellous bone healed by direct formation of woven bone. Instability resulted in an internal ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::This biographical sketch on Themistocles Gluck corresponds to the historic text, The Classic: Report on the positive results obtained by the modern surgical experiment regarding the suture and replacement of defects of superior tissue, as well as the utilization of re-absorbable and living tamponade in surgery (1891),...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章
doi:10.1007/s11999-011-1836-8
更新日期:2011-06-01 00:00:00
abstract::Eight patients with osteochondritis dissecans of the talus were reviewed. The average followup was 17.6 months (range, 8-26 months). The mean age of the patients was 31.8 years (range, 22-42 years). All patients had a preoperative examination, magnetic resonance imaging, and radiologic classification of the lesion thr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200202000-00021
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:The majority of published functional outcome data for tumor megaprostheses comes in the form of subjective functional outcome scores. Sparse objective data exist demonstrating functional results, activity levels, and efficiency of gait after endoprosthetic reconstruction in patients treated for orthopaedic t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3655-1
更新日期:2015-03-01 00:00:00
abstract::Spinal traction is a time-honored method for the treatment of disc protrusion, degenerative disc disease, and joint dysfunction. Effective treatment is not as easy or as simple to administer as it may appear. Many variations of technique exist, some of questionable value. It must be emphasized that spinal traction is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-10-01 00:00:00
abstract::In adult rabbits, a unilateral subcapital osteotomy of the femoral neck was performed to induce avascularity. One half of the osteotomy sites were fixed with a magnetic resonance imaging (MRI) compatible absorbable pin and the other osteotomies had no fixation. The femoral heads were studied at three, five, and 12 day...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Twelve cases of supracondylar fracture of the femur in rheumatoid arthritis patients with previously implanted resurfacing or MacIntosh arthroplasty of the knee had long standing severe polyarticular rheumatoid arthritis (duration, ten to 41 years; mean 24.8 years). The fractures occurred following a long interval aft...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::Sixty consecutive revision total hip arthroplasties were performed with bulk allograft bone supported by the Kerboull reinforcement acetabular device in 53 patients from 1980 to 1987. The average age of the patients at the time of hip revision was 57.7 years. Acetabular bone loss according to the American Academy of O...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200009000-00025
更新日期:2000-09-01 00:00:00
abstract::Insufficient posterior tibial tendons in 28 specimens from patients with clinical Stage II or III disease were examined to clarify the etiology of adult-acquired flatfoot deformity. Hematoxylin and eosin and Masson trichrome-stained sections of formalin-fixed tissue were viewed in plain and polarized light. We perform...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000218759.42805.43
更新日期:2006-09-01 00:00:00
abstract::Two neonates required deep hypothermia and circulatory arrest to provide a central control of blood loss for the resection of giant cavernous hemangiomas. Both infants were placed on cardiopulmonary bypass, cooled to 16 degrees, and exsanguinated before resection of these peripheral lesions. The surgery was done as a ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Readmissions after total joint arthroplasty have become a key quality measure in elective surgery in the United States. The Affordable Care Act includes the Hospital Readmission Reduction Program, which calls for reduced payments to hospitals with excessive readmissions. This policy uses a method to determin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-5156-x
更新日期:2017-05-01 00:00:00
abstract::Dislocation is a well documented complication after a two-stage revision arthroplasty for a deep periprosthetic hip infection. We are aware of no reports specifically evaluating the risk factors for dislocation after reimplantation for infection. We hypothesized greater age, increase in the number of operations on the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000218747.92118.3a
更新日期:2006-06-01 00:00:00
abstract::External fixation is the treatment of choice for fractures of the leg involving severe damage to the soft tissue. Each of the various patterns of application has advantages and disadvantages. Based on various biomechanical studies and clinical experience, the authors use a right-angle arrangement for the screws. If th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract::The tibialis anterior tendon transfer has been used in the treatment of recurrent congenital clubfoot and paralytic equinovarus foot deformities in cerebral palsy. This study attempts to determine the optimal site of tibialis anterior tendon insertion for ankle and foot motion and to compare the split and whole tendon...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199804000-00031
更新日期:1998-04-01 00:00:00
abstract::Titanium implants are an alternative to stainless steel implants for internal fixation after fracture. The advantages of titanium include decreased implant stiffness, increased bio-compatibility, and diminished stress shielding. However, titanium has been implicated in tendon irritation and adhesions when used in the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000205894.98361.29
更新日期:2006-04-01 00:00:00
abstract::Costameres, structures at the plasma membrane of skeletal muscle, are present in a rectilinear array that parallels the organization of the underlying contractile apparatus. Costameres have three major functions: to keep the plasma membrane, or sarcolemma, aligned and in register with nearby contractile structures; to...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200210001-00024
更新日期:2002-10-01 00:00:00
abstract::Forty-two months follow-up examinations on 30 total knee arthroplasties revealed the following significant complications: phlebothrombosis, 13 knees (46%); pulmonary embolism 3 patients (11%); asymptomatic loosening, 8 knees (11.4%); symptomatic loosening, 3 knees (4.8%); superficial infections, 4 knees (5.4%); deep i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::Dissociation of the polyethylene liner from its metal shell has been reported as a rare occurrence. During a 4-year period, six hips in five patients who had the Harris-Galante II porous acetabular component implanted as part of a primary or revision total hip arthroplasty presented with acute onset of pain and diffic...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200105000-00021
更新日期:2001-05-01 00:00:00