{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:48Z","timestamp":1787755308776,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>Two young adult patients, 22 and 27 years, who sustained ballistic long bone fractures, presented for incarcerated, retained metallic fragments in the medullary canal, which blocked fixation. Owing to the presence and location of the fragments, each case required a bullectomy (removal of the metallic fragment) before intramedullary nail fixation because the projectile impeded the appropriate insertion of the intramedullary rod and, in one case, induced fracture malalignment. Attempts at removal using conventional tools did not provide adequate length or grasp of the retained projectile, necessitating the use of the novel technique. The Babcock Laparoscopic Endopath is an easy-to-use, ubiquitous tool that facilitates the removal of content within the intramedullary canal, including metallic or bony fragments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is limited literature describing accessible, cost-effective techniques for the removal of intramedullary retained metallic foreign fragments when it is unremovable through conventional means. This article reports on a novel, minimally invasive technique for bullet removal from the intramedullary canal of the femur and tibia using the Babcock Laparoscopic Endopath, a tool typically used by urologists. Both patients were followed for at least 8 weeks postoperatively with no complications secondary to the procedure. The article describes the technique and advantages of using this readily available tool that is both flexible enough to navigate through the intramedullary canals as well as rigid enough to obtain and manipulate metallic objects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.23.00278","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T14:04:34Z","timestamp":1696514674000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bullet Fragment Retrieval During Intramedullary Nailing"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3975-441X","authenticated-orcid":false,"given":"Jordan Cook","family":"Serotte","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2652-5197","authenticated-orcid":false,"given":"Cathleen","family":"Cahill","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-1595","authenticated-orcid":false,"given":"Jason A.","family":"Strelzow","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10]]},"reference":[{"issue":"8","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1001\/jama.2018.10060","article-title":"Global mortality from firearms, 1990-2016","volume":"320","author":"Naghavi","year":"2018","journal-title":"JAMA."},{"issue":"6","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/00005131-199708000-00009","article-title":"Intraarticular findings after gunshot wounds through the knee","volume":"11","author":"Tornetta","year":"1997","journal-title":"J Orthop Trauma."},{"issue":"4","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s00590-022-03220-3","article-title":"Gunshot-related lower extremity nerve injuries","volume":"33","author":"Baker","year":"2023","journal-title":"Eur J Orthop Surg Traumatol."},{"issue":"3","key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.injury.2018.01.027","article-title":"Variation in treatment of low energy gunshot injuries: a survey of OTA members","volume":"49","author":"Nguyen","year":"2018","journal-title":"Injury."},{"issue":"3","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1097\/00000658-198203000-00010","article-title":"Lead poisoning from retained bullets. Pathogenesis, diagnosis, and management","volume":"195","author":"Linden","year":"1982","journal-title":"Ann Surg."},{"issue":"3","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/0002-9343(79)91083-0","article-title":"Lead poisoning from a gunshot wound. Report of a case and review of the literature","volume":"66","author":"Dillman","year":"1979","journal-title":"Am J Med."},{"issue":"6","key":"bib9-20240805","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1289\/ehp.7596","article-title":"Lead exposure inhibits fracture healing and is associated with increased chondrogenesis, delay in cartilage mineralization, and a decrease in osteoprogenitor frequency","volume":"113","author":"Carmouche","year":"2005","journal-title":"Environ Health Perspect."},{"issue":"5","key":"bib10-20240805","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2106\/00004623-197456050-00016","article-title":"Low-velocity gunshot wounds involving the knee joint: surgical management","volume":"56","author":"Ashby","year":"1974","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib11-20240805","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1097\/BOT.0b013e3181cf03ea","article-title":"Civilian gunshot wounds of the hip and pelvis","volume":"24","author":"Bartkiw","year":"2010","journal-title":"J Orthop Trauma."},{"issue":"3","key":"bib12-20240805","first-page":"577","article-title":"Management of gunshot pelvic fractures with bowel injury: is fracture debridement necessary?","volume":"71","author":"Rehman","year":"2011","journal-title":"J Trauma."},{"issue":"12","key":"bib13-20240805","doi-asserted-by":"crossref","first-page":"3956","DOI":"10.1007\/s11999-013-3260-8","article-title":"Retained bullet removal in civilian pelvis and extremity gunshot injuries: a systematic review","volume":"471","author":"Riehl","year":"2013","journal-title":"Clin Orthop Relat Res."},{"issue":"10","key":"bib14-20240805","first-page":"1287","article-title":"Identifying and managing adverse environmental health effects: 3. Lead exposure","volume":"166","author":"Sanborn","year":"2002","journal-title":"CMAJ."},{"issue":"2","key":"bib15-20240805","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/01.TA.0000119205.24520.1D","article-title":"Elevation of blood lead levels in emergency department patients with extra-articular retained missiles","volume":"58","author":"Nguyen","year":"2005","journal-title":"J Trauma."},{"issue":"3","key":"bib16-20240805","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/BOT.0b013e3181ea5cb9","article-title":"The role of d\u00e9bridement in low-velocity civilian gunshot injuries resulting in pelvis fractures: a retrospective review of acute infection and inpatient mortality","volume":"25","author":"Watters","year":"2011","journal-title":"J Orthop Trauma."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:40:59Z","timestamp":1787751659000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.23.00278"}},"subtitle":["A Report of 2 Cases"],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.23.00278","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]}}}