Bilateral central acetabular fracture dislocations secondary to sustained myoclonus

Abstract

This case report presents a patient with bilateral central acetabular fracture dislocations secondary to sustained myoclonus treated with delayed bilateral total hip arthroplasty. This is an unusual mechanism of injury, but is similar to other uncontrolled muscular contractions, such as electroconvulsive therapy and seizures. Because of ongoing myoclonus, the patient initially was treated nonoperatively. The patient then successfully had staged bilateral total hip arthroplasty 15 months after injury. This case exemplifies that forceful, uncontrolled muscular contraction can cause bilateral symmetric fracture dislocations. In patients with a history of seizure or myoclonic contracture with subsequent pain or loss of function, radiographs are indicated and skeletal fracture or joint dislocation must be ruled out. Secondary reconstruction can be recommended when the patient is medically stable.