{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:52:27Z","timestamp":1773417147663,"version":"3.50.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>To evaluate whether operative irrigation and debridement (I&amp;D) is necessary for the treatment of pediatric traumatic arthrotomies (TAs) secondary to gunshot wounds (GSWs) to prevent joint infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>US Academic Level I Trauma Center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Selection Criteria:<\/jats:title>\n                    <jats:p>Pediatric patients (age 0\u201317) with TAs secondary to GSW between 2016 and 2023 with at least 1-month follow-up were included. Arthrotomies included shoulder, elbow, wrist, hand, sacroiliac, hip, knee, ankle, or foot joints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures and Comparisons:<\/jats:title>\n                    <jats:p>The primary outcome was rate of joint infection between those who received acute operative I&amp;D versus those who received nonoperative management. A subanalysis was completed only comparing \u201cmajor joints.\u201d Within the cohorts, length of antibiotic treatment was compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Fifty seven cases of ballistic TA (50 subjects, 82% male, mean age 14.6 years) were included. In total, 31 of 57 joints (54.4%) underwent formal operative I&amp;D with or without fixation, while 26 joints (45.6%) did not. In the operative I&amp;D cohort, 85% were male with a mean age 14.8 years versus 79% male with mean age of 14.3 years in the nonoperative group. Mean follow-up duration was 10.8 months (range 1\u201356 months) for both cohorts. No joint infections were documented between either group, regardless of treatment (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.0). In total, 38 TAs were major joints: 23 of 38 (60.5%) received I&amp;D, while 15 of 38 (39.5%) did not. All joints received at least 1 dose of intravenous (IV) antibiotics. Among the operative group, 54.8% of joints received \u226472 hours of IV antibiotics (45.2% received &gt;72 hours), compared with 46.2% of joints in the nonoperative group (53.8% received &gt;72 hours).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Formal operative I&amp;D was not found to be necessary to prevent joint infection after TA secondary to GSW. Prolonged antibiotic use did not affect rates of infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/bot.0000000000003129","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T14:01:31Z","timestamp":1763647291000},"page":"182-188","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and Management for Ballistic Traumatic Arthrotomies in Children"],"prefix":"10.1097","volume":"40","author":[{"given":"Nicholas L.","family":"Newcomb","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7999-4559","authenticated-orcid":false,"given":"Devin A.","family":"Maez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5693-7931","authenticated-orcid":false,"given":"Samuel 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