RT Journal
A1 Dougherty, Paul J.
A1 van Holsbeeck, Marnix
A1 Mayer, Theodore G.
A1 Garcia, A. Joseph
A1 Najibi, Soheil
T1 Lead Toxicity Associated with a Gunshot-Induced Femoral FractureA Case Report
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2009
FD August 1
VO 91
IS 8
SP 2002
OP 2008
DO 10.2106/JBJS.H.01077
UL http://dx.doi.org/10.2106/JBJS.H.01077
AB 
Lead toxicity due to a bullet or bullet fragment is a rare complication of gunshot wounds1-17. Surgeons who manage patients with these injuries are aware of lead toxicity in association with lead arthropathy4,11,18-26, but cases that involve lead toxicity due to extra-articular lead fragments in the extremities are unusual. The presence of bullet fragments in tissue can increase the serum concentration of lead to above average, but not to the levels seen in patients with lead toxicity15,16,27. Cysts associated with a gunshot wound to bone28,29, the joints19,30-32, or the spine8,33 have been described. We describe the case of a patient with lead toxicity due to an extra-articular cyst associated with retained lead fragments after a gunshot-induced fracture of the femoral shaft. The cyst encasing the bullet fragments developed by twenty-one months after the injury. The patient was informed that data concerning the case would be submitted for publication and he consented.