Case Report Volume 7 • Issue 2 129 Arthroscopic Removal of Shoulder Joint Embedded Gunshot Bullet: A Case Report Joseph E Nassar 1 , Yehia Tfayli 2 , Mohamad Issa 1 , Akram Al Ramlawi 1 , Ahmad Naja 1* Afliation: 1 Orthopaedic Surgery Department, American University of Beirut Medical Center, Beirut, Lebanon 2 Jeferson Health Northeast 3B Orthopaedics, Philadelphia PA, USA *Corresponding Author Ahmad Naja, Orthopaedic Surgery Department, American University of Beirut Medical Center, Beirut, Lebanon. Citation: Joseph E Nassar, Yehia Tfayli, Mohamad Issa, Akram Al Ramlawi, Ahmad Naja. Arthroscopic Removal of Shoulder Joint Embedded Gunshot Bullet: A Case Report. Archives of Clinical and Medical Case Reports. 7 (2023): 129-132. Received: February 14, 2023 Accepted: February 28, 2023 Published: March 16, 2023 Abstract Joint related gunshot injuries encompass signifcant morbidity if left untreated. Open and arthroscopic procedures are the main stay treatment for removal of foreign body. Nevertheless, there is no defnitive management due to the scarcity of cases in the literature. We report the case of a white Arab 38-years-old man with a high velocity gunshot wound leading to bullet dislodgement in the left glenohumeral joint. The patient’s wound was treated with arthroscopy, extensive debridement, and decompression of subacromial space with partial acromioplasty. Keywords: Arthroplasty; Case Report; Gunshot; Glenohumeral Joint; Rochester-Pean Forceps Abbreviations: GSW- Gunshot wound; GS- Gunshot Introduction Around 30,000 patients are being hospitalized in the US due to gunshot wounds (GSW) and 2500 die due its wound complications [1]. Shoulder gunshot (GS) injuries are around 9% of gunshot injuries [2]. No clear consensus is present in current literature regarding the defnitive management of joint afected gunshot injuries. Few case reports tackled GS injuries by arthroscopic debridement, antibiotic therapy, and tetanus prophylaxis. Joint afected GS injuries encompass several complications mainly because of possible retained intra-articular foreign bodies that might afect joint mechanics resulting in early onset arthritis [3, 4]. With that being said, arthroscopic washout and removal of foreign bodies are important to prevent GS injuries related complications. We report a case of high velocity gunshot wound leading to bullet dislodgement in the left glenohumeral joint associated with minimally displaced proximal humeral head fracture. The patient’s wound was treated with arthroscopy, extensive debridement, and decompression of subacromial space with partial acromioplasty. Consent regarding the submission and publication of this case report has been provided by the concerned patient. Case Report A 39-year-old Lebanese male presented conscious to the emergency room on the 19 th of December 2021, with a single gunshot wound at his lateral upper chest, close to the axilla and with no exit wound, leaving a 1.6 cm metallic bullet ‘Figure 1A’. The incident was due to a high velocity gunshot fred at approximately 30 cm. On the physical exam, the patient’s range of motion was limited due to pain and with an open wound of 2.5 cm. Also, the patient was neurovascular intact. He had limited active shoulder fexion, abduction and no external or internal rotation. Any passive movement was eliciting pain.