Table 1 Major endpoints of two prospective [11, 12] and twelve retrospective reviews on penetrating buttock injury in acute trauma setting
From: Analytical review of 664 cases of penetrating buttock trauma
Study/reference | Period years | Patients | Male | Mean age | Viscus/major vessel injury | Bony ring injury | Mean ISS | Major surgery* | Overall mortality | Morbidity in survivals | Concominant injuries | Hospital stay†| Cited articles | Contribution/concern |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Velmahos et al.[11] (1997) | 1 | 59 | 58 | 23 | 17 (29%) | 5 (8%) | - | 19(32.2%) | 0 | 3 (15.8%) | High | 7.2 | 11 | Clinical examination is very accurate |
Velmahos et al.[12] (1998) | 1 | 10 | - | - | - | - | - | - | 0 | - | - | - | 14 | Clinical examination is a reliable predictor |
Maull et al. [13] (1979) | 5 | 15 | 11 | 29 | 6 (54.5%) | - | - | 12 | 0 | 5 (33%) | 0 | 12 | 0 | Liberal laparotomy advocated |
Ivatury et al. [4] (1982) | 4 | 60 | 57 | - | 16 (26.7%) | 3 (5%) | - | 16 (26.7%) | 2 (3%) | 14 (23%) | - | 2 vs 18 | 3 | Aggressive management |
Vo et al. [5] (1983) | 5 | 20 | 18 | 32 | 5 (25%) | 2 (10%) | - | 12 (60%) | 0 | 5 (25%) | 10 (50%) | - | 2 | Bullet's trajectory is important |
Fallon et al. [14] (1988) | - | 51 | 43 | 28.9 | 16 (31%) | 0 | - | 25 (49%) | 0 | 4 (8%) | High | - | 4 | Thorough evaluation and all investigations |
Gilroy et al. [15] ( 1992) | 6 | 8 | 7 | 33 | 8 | - | - | 8 | 2 (25%) | 0 | 0 | - | 9 | Danger of gluteal incision: vessels |
Mercer et al. [3] (1992) | 6 | 81 | 75 | 26 | 18 (22%) | 4 (5%) | - | 26% (21) | 1 (1.2%) | - | - | - | 6 | Two zones of buttock: upper vs lower |
Ferraro et al. [16] (1993) | 2 | 70 | 68 | 25 | 34 (49%) | 7 (17%) | 11(1-45) | 34 (49%) | 3 (4%) | - | - | - | 8 | Sigmoidoscopy advocated |
DiGiacomo et al. [2] (1994) | 3 | 73 | 71 | - | 24 (33%) | 10 (14%) | - | 27 (37%) | 1 (1.4%) | 9 (12%) | - | - | 10 | Transpelvic bullet trajectory: surgery |
Makrin et al. [17] (2001) | 5 | 17 | 17 | 27 | 4 (23.5%) | 0 | - | 2 (11.8%) | 0 | 1 (6%) | 0 | 4 (1-16) | 5 | Upper zone wounds carry higher risk |
Susmallian et al. [18](2005) | 5 | 39 | 38 | - | 4 (10.5%) | - | - | 2 (5.1%) | 0 | 0 | 0 | - | 6 | Meticulous observation |
Ceyran et al.[19] (2009) | 17 | 27 | 27 | - | - | 0 | - | 25 (93%) | 3 (11.1%) | 1 (4.2%) | 0 | 8 (7 -11) | 7 | Surgical approach and technique, if needed |
Lesperance et.[10] (2009) | 1.33 | 115 | 113 | 28 | 36 (31%) | 40 (35%) | 13 (1-75) | 87 (76%) | 7 (6%) | 16 (14%) | 66 (57%) | - | 24 | Military surgery experience |
Summary | 1 - 17 | 8 - 115 | Most | Young | 10.5 - 54.5% | 0 - 35% | 11 - 13 | 5.1 - 93% | 0 - 25% | 0 - 33% | High | Long | 0 - 24 | Dangerous injury/Contingencies possible |