Post-traumatic Acetabular Defect with Ipsilateral Distal Shaft Femur Infected Nonunion Treated with Staged Osteosynthesis and Acetabular Reconstruction THA

Anil Thomas Oommen; Christo Jeyaraj; Rahul George; Ramu Viswarajan V

doi:10.5005/ijoa-11025-0009

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Post-traumatic Acetabular Defect with Ipsilateral Distal Shaft Femur Infected Nonunion Treated with Staged Osteosynthesis and Acetabular Reconstruction THA

Anil Thomas Oommen, Christo Jeyaraj, Rahul George, Ramu Viswarajan V

Keywords : Acetabular defect, Case report, Femur shaft nonunion, Infection, Reconstruction total hip arthroplasty, Staged

Citation Information : Oommen AT, Jeyaraj C, George R, V RV. Post-traumatic Acetabular Defect with Ipsilateral Distal Shaft Femur Infected Nonunion Treated with Staged Osteosynthesis and Acetabular Reconstruction THA. Ind J Arthroplasty 2024; 1 (2):73-76.

DOI: 10.5005/ijoa-11025-0009

License: CC BY-NC 4.0

Published Online: 31-12-2024

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Abstract

Post-traumatic arthritis with bone defects occurs following sequelae of comminuted acetabular fractures after fixation. Hip center restoration with acetabular reconstruction at total hip arthroplasty (THA) is required. Infected treated ipsilateral fracture shaft of the femur presented a challenge for this 46-year-old gentleman. Debridement of the femur fracture was done after implant removal, followed by staged fixation after appropriate antibiotic therapy. Stable fixation was achieved with an intramedullary nail with a lateral locking plate. Hip implant removal, debridement and cement spacer were done, followed by THA at the subsequent stage. Stable acetabular reconstruction was done with a sector augment and a cementless shell to restore the hip center. Femoral preparation was done with care to avoid the proximal screw of the plate fixation. Mobilization with a gradual increase in weight-bearing was done. He is doing well at a 2-year follow-up with a united femur fracture, knee movement of 120 degrees, and 1 cm shortening.

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