DELAYED MANAGEMENT OF ACETABULAR FRACTURES BY OPEN REDUCTION AND INTERNAL FIXATION: A CASE REPORT OF FAILED REDUCTION AND LITERATURE REVIEW

Background. Acetabular fractures are complex injuries often resulting from high-energy trauma. Timely open reduction and internal fixation (ORIF) is considered gold standard for these cases. However, in polytrauma pa­tients, management can be delayed due to systemic ins­tability which increases the risk of complications such as infection and avascular necrosis (AVN). These adverse outcomes may require conversion to total hip arthroplasty (THA) which is much more challenging in the setting of previous fixation.

Case presentation. We report a case of a polytrauma pa­tient with multiple pelvic fractures, sustained in a motor vehicle collision. Delayed fracture management of the acetabulum via open reduction and internal fixation resul­ted in surgical site infection, poor anatomical alignment of the acetabulum and avascular necrosis of the femoral head necessitating early total hip arthroplasty conversion.

Conclusions. This case reinforces the importance of ti­mely fixation of acetabular fractures to reduce risks of infection and avascular necrosis. Additionally, it demons­trates that staged total hip arthroplasty can be successful treatment of choice in cases of failed ORIF.