Outcomes and Management for Ballistic Traumatic Arthrotomies in Children
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View abstract on PubMed
Summary
This summary is machine-generated.Operative irrigation and debridement (I&D) is not necessary for pediatric traumatic arthrotomies from gunshot wounds to prevent joint infections. Prolonged antibiotic use also did not impact infection rates in this study.
Area Of Science
- Orthopedic Surgery
- Trauma Surgery
- Pediatric Surgery
Background
- Traumatic arthrotomies (TAs) in pediatric patients resulting from gunshot wounds (GSWs) pose a risk of joint infection.
- The necessity of operative irrigation and debridement (I&D) in managing these injuries remains a critical clinical question.
Purpose Of The Study
- To determine if operative I&D is essential for preventing joint infections in pediatric patients with TAs secondary to GSWs.
- To compare infection rates between operative I&D and nonoperative management for these injuries.
Main Methods
- A retrospective cohort study was conducted at a US Academic Level I Trauma Center.
- Pediatric patients (0-17 years) with TAs from GSWs between 2016-2023 were included, with follow-up of at least one month.
- The primary outcome was the rate of joint infection, comparing operative I&D versus nonoperative management, with a sub-analysis for major joints.
Main Results
- The study included 57 cases of ballistic TA in 50 pediatric patients. 54.4% underwent operative I&D, while 45.6% received nonoperative management.
- No joint infections were documented in either the operative or nonoperative groups (p=1.0).
- Antibiotic treatment duration did not correlate with infection rates; 45.2% of the operative group and 53.8% of the nonoperative group received >72 hours of IV antibiotics.
Conclusions
- Formal operative I&D is not a necessary intervention to prevent joint infections following traumatic arthrotomies secondary to gunshot wounds in pediatric patients.
- The duration of antibiotic treatment did not influence the occurrence of joint infections in this cohort.
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