{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:42:20Z","timestamp":1787755340350,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Case:<\/jats:title>\n A 38-year-old man with a tibial plateau fracture required treatment for elevated blood lead level (BLL) from retained bullet fragments in the same knee from a gunshot wound 21 years earlier. Oral succimer presurgery and postsurgery decreased the BLL from 58 to 15 \u03bcg\/dL.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Parenteral chelation has been previously recommended to mitigate an increase in BLLs during surgical intervention to remove bullet fragments. Oral succimer was an effective and well-tolerated alternative to intravenous chelation. Further research is needed to determine the optimal route, timing, and duration of chelation in patients with elevated BLL in need of bulletectomy.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.cc.23.00011","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T14:01:38Z","timestamp":1686837698000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Succimer Mitigates the Perioperative Risk for an Increase in Blood Lead Levels During Bulletectomy"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1749-3780","authenticated-orcid":false,"given":"Joseph M.","family":"Kennedy","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Vermont Medical Center, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne C.","family":"Routsolias","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine\/Toxicology\/Pharmacy, Cook County Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-9962","authenticated-orcid":false,"given":"Mark B.","family":"Mycyk","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Cook County Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4]]},"reference":[{"key":"bib1-20240731","first-page":"472","article-title":"A case of probable lead-poisoning, resulting fatally from a bullet lodged in the knee-joint twelve years previously","volume":"91","author":"Ellis","year":"1874","journal-title":"Boston Med Surg J."},{"issue":"10","key":"bib2-20240731","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1080\/15563650.2022.2116336","article-title":"Retained 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