Bilateral acetabular fractures induced by an epileptic seizure in a paediatric patient: a unique case and its management. Issue 8 (21st August 2019)

• Record Type: Journal Article
• Authors: Mohamed, Nusrat; Makaranka, Stanislau; Cheema, Kamalpreet; Harnett, Paul
• Is Part Of: BMJ case reports. Volume 12:Issue 8(2019)
• Publication Date: 2019-08-21
• Subjects: orthopaedics -- paediatrics; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-230143
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Bilateral acetabular fractures following epileptic seizures are a rare but known occurrence in adults, with an 18.5% mortality rate. These fractures occurring post epileptic seizures have not been previously documented in children. We report a case of a 13-year-old boy who presented to hospital via ambulance following two violent generalised tonic–clonic seizures in a postictal state, metabolically acidotic and a low haemoglobin. Acute abdomen was suspected and the patient underwent a CT scan which showed bilateral acetabular fractures with central dislocations of both femoral heads and free fluid in the abdomen. The patient underwent initial damage control intervention with insertion of bilateral distal femur skeletal traction. Definitive fixation of the acetabular fractures occurred 1 week later with an open reduction internal fixation with novel supra-pectineal plates using a Pfannenstiel incision. We use this report to increase awareness of significant pelvic injuries in paediatric patients post epileptic seizures.