20 A pellet that has penetrated a joint or is associated with a fracture requires skilled orthopaedic management. A pellet lodged near a major blood vessel or nerve should ideally be removed.18 The possibility of intravascular embolism must be considered if the pellet is absent from a suspected entry site and there is no exit wound; numerous examples of arterial and venous embolism of an air weapon pellet in children have been described.6
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