A rare case of bilateral central subluxation of the hip joint with associated bilateral quadrilateral plate fracture in an elderly male due to seizure activity

Abstract

Musculoskeletal injuries such as dislocation of the shoulder and hip joints and fractures of the femoral neck are known complications of seizures. Bilateral central subluxation of the hip joint with associated bilateral quadrilateral plate fracture is a rare entity and is prone to delayed diagnosis, even more so in patients who experience post-seizure disorientation. The authors report the case of a 74-year-old male patient with bilateral central subluxation of the hip joint with associated bilateral quadrilateral plate fracture due to seizure activity. Bilateral open reconstruction and fixation of the quadrilateral plate with a 3.5-mm pre-bent reconstruction plate reinforced with 3.5-mm pelvic brim reconstruction plate was performed. In conclusion, this case is an example of rare bilateral quadrilateral plate fracture caused due to seizure activity, a fracture for which a high level of suspicion should be kept in mind while evaluating the patient post-seizure episode.

Bilateral acetabular fractures treated with delayed total hip arthroplasty

“…Mortality may be due to massive blood loss from the pelvic fractures, or from sepsis secondary to sacral ulcers sustained during prolonged periods of bedrest [3,4]. The literature on acetabulum fractures after seizures mostly describes nonoperative management using a period of traction, followed by progressive weight bearing around 3 months [2][3][4][5][6][7][8][9].…”

“…Forceful contraction of the muscles around the hip during a seizure can cause the femoral head to drive medially and proximally, leading to a central fracture dislocation of the hip with medialization of the femoral head. Most prior case reports have treated seizure-induced bilateral acetabular fractures nonoperatively, with prolonged periods of traction or with internal fixation [2][3][4][5][6]. We present a case of a 76-year-old man who sustained bilateral acetabular fractures after a seizure and was treated with delayed bilateral total hip arthroplasty using acetabular impaction bone grafting.…”

Digital anatomical study and clinical application of screw placement for quadrilateral plate fractures in the danger zone

“…In addition, T-type fractures, anterior column and posterior hemi-transverse fractures, posterior column and transverse fractures involve this inside wall [27,28]. Open reduction and internal fixation with spring plates, H-shaped, T-shaped, L-shaped and reconstruction plates buttressing the quadrilateral surface, even with cerclage wires are common methods [29][30][31]. In some other studies, buttress plates have proven helpful in maintaining the quadrilateral surface or medial acetabular wall [21,32].…”

Digital anatomical study and clinical application of screw placement for quadrilateral plate fractures in the danger zone

“…In addition, T-type fractures, anterior column and posterior hemitransverse fractures, posterior column and transverse fractures involve this inside wall [27,28]. Open reduction and internal fixation with spring plates, H-shaped, T-shaped, L-shaped and reconstruction plates buttressing the quadrilateral surface, even with cerclage wires are common methods [29][30][31]. In some other studies, buttress plates have proven helpful in maintaining the quadrilateral surface or medial acetabular wall [21,32].…”