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Case Reports
. 2018 Oct 13:18:56-59.
doi: 10.1016/j.tcr.2018.07.003. eCollection 2018 Dec.

Femoroacetabular impingement as a complication of acetabular fracture fixation

David A Zuelzer  1 , Christopher B Hayes  1 , Raymond D Wright  1 , Stephen T Duncan  1
Affiliations
Case Reports

Femoroacetabular impingement as a complication of acetabular fracture fixation

David A Zuelzer et al. Trauma Case Rep. .

Abstract

Case: We present the case of a thirteen-year-old female who sustained a posterior wall acetabular fracture dislocation. She underwent urgent closed reduction and subsequent uncomplicated open reduction and internal fixation. Post reduction computed tomography demonstrated a concentrically reduced hip joint with no evidence of femoroacetabular impingement (FAI). She subsequently healed her fracture and returned to running activities; however, one year later presented with aching pain in her thigh. Radiographs demonstrated the development of a large osseous prominence on her anterolateral femoral neck consistent with femoroacetabular impingement. Based on these findings she was evaluated by a hip preservation specialist. She subsequently underwent successful hip arthroscopy for labral repair and femoral osteochondroplasty. She was eventually able to return to running sports with little pain.

Summary: We present a case of FAI presenting as a complication of acetabular fracture fixation. This should be discussed with patients presenting with traumatic hip dislocations as a possible complication of surgical fixation or possibly of the injury itself.

Keywords: Acetabular fracture; Complication; Femoroacetabular impingement; Hip arthroscopy.

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Figures

Fig. 1
Fig. 1
A–C. A). 3D Recon image of a right posterior wall acetabulum fracture. B). Immediate postoperative radiographs and C) immediate postoperative CT scan showing interval hardware placement and no preexisting CAM lesion.
Fig. 2
Fig. 2
A and B. Representative slices of CT scans at the same depth taken 2 years apart demonstrate the interval development of CAM lesion of femoral head. A). Immediate postoperative CT scan. B). 14 months postoperatively the posterior wall fracture has healed with no degenerative changes seen. There has been interval development of a CAM lesion.
Fig. 3
Fig. 3
A–C. A). Preoperative radiograph taken before hip arthroscopy and femoral osteochondroplasty. B). Dunn view taken with fluoroscopy intraoperatively and C). Follow-up radiographs taken 1 year after hip arthroscopy and femoral osteochondroplasty. Note that there is no evidence of recurrence at 1 year following osteochondroplasty.
See this image and copyright information in PMC

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