title: Successful treatment of a delayed presentation of a gunshot injury to the femoral neck in an elderly man: a case report.
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.
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.
authors.forename: Cheng-Jung
authors.initials: CJ
authors.lastname: Ho
authors.affiliation: Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Orthopedic Surgery, Fooyin University Hospital, Tungkang Chen, Ping-Tung County, Taiwan.
authors.forename: Shao-Hung
authors.initials: SH
authors.lastname: Hung
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.|Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hsuan-Ti
authors.initials: HT
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.|Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Orthopaedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Peng-Ju
authors.initials: PJ
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.|Department of Orthopaedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Sung-Yen
authors.initials: SY
authors.lastname: Lin
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.|Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yin-Chih
authors.initials: YC
authors.lastname: Fu
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.|Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Jian-Chih
authors.initials: JC
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan.|Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Cheng
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University and Hospital, Tainan City, Taiwan.
authors.forename: Lin
authors.initials: L
authors.lastname: Kang
authors.affiliation: Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No 100 Tzu-You 1st Road, Kaohsiung, Taiwan. hwan@kmu.edu.tw.|Departments of Orthopaedics, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. hwan@kmu.edu.tw.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. hwan@kmu.edu.tw.|Orthopaedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan. hwan@kmu.edu.tw.|Department of Sports Medicine, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. hwan@kmu.edu.tw.
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Chen
keywords: Ballistic injury; Delayed treatment; Femoral neck fracture; Hemiarthroplasty; Plumbism