title: Surgical hip dislocation for removal of retained intra-articular bullets.
abstract: BACKGROUND
  Surgical hip dislocation with trochanteric osteotomy was introduced for the treatment of femoroacetabular impingement and other intra-articular pathologies of the hip. We expanded the indications to include removal of retained bullets in the hip joint as an alternative to hip arthroscopy.
  
  
  METHODS
  We present a prospective case series of ten patients that were treated with a surgical hip dislocation for removal of retained bullets in the hip joint between January 2014 and October 2015 in a Level 1 trauma centre. The main outcome measurements were successful bullet removal, blood loss, surgical time and intraoperative complications.
  
  
  RESULTS
  There were 8 males and 2 females with a mean age of mean age 27.3 years (range 20-32). All patients had one whole retained bullet for removal (right side: 8; left side: 2). In all cases the bullet could be removed in its entirety. The average surgical time was 73min (range 55-125) and the average blood loss 255ml (range 200-420).
  
  
  CONCLUSIONS
  Surgical hip dislocation provides an unlimited view of the acetabulum and femoral head and neck and it therefore allows for easy removal of retained bullets. Osteocartilaginous lesions and concomitant fractures of the femoral head can be simultaneously evaluated and treated.
authors.affiliation: Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Sithombo
authors.initials: S
authors.lastname: Maqungo
authors.affiliation: Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland. Electronic address: sven.hoppe@insel.ch.
authors.forename: Sven
authors.initials: S
authors.lastname: Hoppe
authors.affiliation: Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Jimmy N
authors.initials: JN
authors.lastname: Kauta
authors.affiliation: Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Graham A
authors.initials: GA
authors.lastname: McCollum
authors.affiliation: Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Maritz
authors.initials: M
authors.lastname: Laubscher
authors.affiliation: Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Michael
authors.initials: M
authors.lastname: Held
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: Marius J B
authors.initials: MJB
authors.lastname: Keel
mesh_terms: D000328:Adult; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging* / Q000601:surgery; D006617:Hip Dislocation; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D013848:Thigh; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000601:surgery*
keywords: Bullet removal; Gunshot; Hip; Retained bullet; Surgical hip disclocation