Posterior wall acetabular fracture in a 13-year-old boy treated by open reduction and mini-plate internal fixation: long-term follow-up of 17 years

Abstract

Background

Acetabular fractures are uncommon in children and adolescents, mainly because of predominant cartilaginous component and strong surrounding ligaments. Although acetabular fractures at this age can lead to significant disability, there is no consensus regarding management, which continues to be controversial. Particularly, long-term outcome after operative management has not been evaluated.

Case presentation

We report a case of a 13-year-old boy skeletally immature who presented with an isolated acetabular fracture involving the posterior wall secondary to a traumatic hip dislocation. A Kocher-Langenbeck approach with a surgical luxation of the hip was used for reduction and mini-plate internal fixation of the fracture. Long-term (17-year) follow-up showed a good clinical outcome and a good congruence of the. The patient has bilateral beginning osteoarthritis due to a cam configuration of both hips

Conclusion

We describe a case of successful operative management of an acetabulum fracture in a skelettaly immature child with a long-term follow-up. Aggressive management of this rare type of fractures may lead to durable positive outcome.

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References

  1. 1.

    Sen MK, Warner SJ, Sama N, Raglan M, Bircher C, Bircher M, Lorich DG, Helfet DL (2015) Treatment of acetabular fractures in adolescents. Am J Orthop 44(10):465–470

    PubMed  Google Scholar 

  2. 2.

    Slongo TF (2013) Acetabulum injuries in infancy and childhood. Unfallchirurg 116(12):1076–1084

    CAS  Article  Google Scholar 

  3. 3.

    Bucholz RW, Ezaki M, Ogden JA (1982) Injury to the acetabular triradiate physeal cartilage. J Bone Joint Surg Am 64(4):600–609

    CAS  Article  Google Scholar 

  4. 4.

    Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U (2001) Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br 83(8):1119–1124

    CAS  Article  Google Scholar 

  5. 5.

    Podeszwa DA, Rocha AD, Larson AN, Sucato DJ (2015) Surgical hip dislocation is safe following acute traumatic hip instability in the adolescent. J Pediatr Ortho 35:435–442

    Article  Google Scholar 

  6. 6.

    Gänsslen A, Hildebrand F, Heidari N, Weinberg AM (2013) Acetabular fractures in children: a review of the literature. Acta Chir Orthop Traumatol Cech 80(1):10–14

    PubMed  Google Scholar 

  7. 7.

    Letournel E (1980) Acetabulum fractures: classification and management. Clin Orthop Relat Res (151):81–106

  8. 8.

    Matta JM (1996) Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 78(11):1632–1645

    CAS  Article  Google Scholar 

  9. 9.

    Laer L (1986) Frakturen und Luxationen im Wachstumsalter. Georg Thieme, pp 256–264

  10. 10.

    Heeg M, de Ridder VA, Tornetta P 3rd, de Lange S, Klasen HJ (2000) Acetabular fractures in children and adolescents. Clin Orthop Relat Res. https://doi.org/10.1097/00003086-200007000-00012

    Article  PubMed  Google Scholar 

  11. 11.

    Davis AT, Moed BR (2013) Can experts in acetabular fracture care determine hip stability after posterior wall fractures using plain radiographs and computed tomography? J Orthop Trauma 27(10):587–591

    Article  Google Scholar 

  12. 12.

    Karunakar MA, Goulet JA, Mueller KL, Bedi A, Le TT (2005) Operative treatment of unstable pediatric pelvis and acetabular fractures. J Pediatr Orthop 25(1):34–38

    PubMed  Google Scholar 

  13. 13.

    Nierenberg G, Volpin G, Bialik V, Stein H (1993) Pelvic fractures in children: a follow-up in 20 children treated conservatively. J Pediatr Orthop 1:140–142

    Article  Google Scholar 

  14. 14.

    Schwarz N, Posch E, Mayr J, Fischmeister FM, Schwarz AF, Ohner T (1998) Long-term results of unstable pelvic ring fractures in children. Injury 29(6):431–433

    CAS  Article  Google Scholar 

  15. 15.

    Silber JS, Flynn JM, Katz MA, Ganley TJ, Koffler KM, Drummond DS (2001) Role of computed tomography in the classification and management of pediatric pelvic fractures. J Pediatr Orthop 21(2):148–151

    CAS  PubMed  Google Scholar 

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Correspondence to Alexandre Simonin.

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Passaplan, C., Simonin, A. & Gautier, E. Posterior wall acetabular fracture in a 13-year-old boy treated by open reduction and mini-plate internal fixation: long-term follow-up of 17 years. Arch Orthop Trauma Surg 140, 1163–1167 (2020). https://doi.org/10.1007/s00402-019-03307-3

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Keywords

  • Acetabular fracture
  • Pediatric orthopaedic surgery
  • Posterior wall fracture
  • Mini-plate internal fixation