Novel Technique for Paired Arthroscopic and Open Retrieval of Incarcerated Ballistic Debris From the Hip

CASES: We describe 2 cases of ballistic hip arthrotomies with retained intra-articular fragments lodged deep to the quadrilateral plate, where arthroscopic retrieval alone may be challenging and often requires an open approach. Both patients were treated using a strategy combining hip arthroscopy for joint debridement and fragment mobilization followed by a Pfannenstiel intrapelvic approach for definitive removal. CONCLUSION: This combined arthroscopic and intrapelvic surgical technique offers an alternative method for addressing difficult-to-access intra-articular ballistic fragments while minimizing additional chondral injury.