Two cases of intra-articular gunshot wounds to the hip associated with sciatic nerve
damage are presented. Both patients had signs of both peroneal and tibial nerve involvement.
Plain films revealed bullet fragments close to the femoral neck. Computerized tomography
(CT scan) confirmed the intra-articular location of the fragments without associated
femoral neck fracture. The patients had surgery for removal of the bullet fragments
in the joint and exploration of the sciatic nerve. Post-operatively the neurological
deficit persisted in both patients. The patients are currently treated for residual
peroneal nerve damage with physiotherapy at eight and six months post injury. A thorough
understanding of the management of intra-articular hip gunshot wounds with or without
nerve involvement is of vital importance to the orthopedic traumatologist working
at an urban level one trauma center. We are reporting two cases and reviewing the
controversial existing literature on this complicated problem.
Missile injuries - intracapsular bullet fragments - lead - neurological damage
