Article ; Online: Operative Versus Nonoperative Management Of Traumatic Arthrotomies from Civilian Gunshot Wounds.
2019 Volume 39, Issue 1, Page(s) 173–177
Abstract: Background: Although the rate of non-fatal gunshot wounds (GSW) has increased, few studies have compared the effectiveness of operative and nonoperative treatment with specific focus on infection. We compared the risk of septic arthritis in patients ... ...
| Abstract | Background: Although the rate of non-fatal gunshot wounds (GSW) has increased, few studies have compared the effectiveness of operative and nonoperative treatment with specific focus on infection. We compared the risk of septic arthritis in patients with traumatic arthrotomies caused by GSW treated operatively with irrigation and debridement versus nonoperatively with antibiotics and wound care. Methods: From 2009 to 2016, 46 patients at our institution sustained traumatic arthrotomies from low-velocity GSW with at least 90-day follow-up. Medical records were reviewed for demographic information, imaging, type and duration of antibiotics, details of operative and nonoperative interventions, and evidence of infection at follow-up visits. We measured the rate of septic arthritis using a 2-tailed Results: The knee was the most commonly affected joint (34 patients; 73.9%). Eight patients (17.4%) were treated nonoperatively and 38 (82.6%) were treated operatively. In the nonoperative group, one patient (12.5%) developed a superficial wound infection that resolved with oral antibiotics. In the operative group, one patient (2.6%) developed a superficial wound infection requiring operative irrigation and debridement. There was no statistically significant difference in risk of infection between the two groups (P = 0.32). No patient developed septic arthritis. Conclusions: In select patients, nonoperative treatment with wound care and antibiotics may be sufficient for preventing infection after GSW-related traumatic arthrotomies. Findings of randomized studies and treatment algorithms are needed to further evaluate this relatively common injury. |
|---|---|
| MeSH term(s) | Adult ; Arthritis, Infectious/etiology ; Arthritis, Infectious/therapy ; Cohort Studies ; Conservative Treatment/methods ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score ; Intra-Articular Fractures/diagnostic imaging ; Intra-Articular Fractures/surgery ; Intra-Articular Fractures/therapy ; Joints/injuries ; Joints/surgery ; Knee Injuries/diagnostic imaging ; Knee Injuries/surgery ; Knee Injuries/therapy ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Treatment Outcome ; Wounds, Gunshot/complications ; Wounds, Gunshot/diagnosis ; Wounds, Gunshot/surgery ; Young Adult |
| Language | English |
| Publishing date | 2019-08-05 |
| Publishing country | United States |
| Document type | Comparative Study ; Journal Article |
| ZDB-ID | 1204065-4 |
| ISSN | 1555-1377 ; 1541-5457 |
| ISSN (online) | 1555-1377 |
| ISSN | 1541-5457 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Se 1381: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.