Published: 2022-02-25

Management of acetabulum fracture with contralateral neck of femur in an obese patient: a rare case report

Sidharth D., Thyagarajan U., Raghavendran B., Raghul Siddharth


Acetabular fractures are complex fractures that pose a challenge for orthopaedic trauma surgeons due to their extension into the hip joint. The simultaneous occurrence of contralateral neck of femur fracture in an obese patient makes postoperative wound healing and rehabilitation even challenging. Here, we report a case of management of acetabulum fracture with contralateral neck of femur fracture in an obese patient. We are reporting a case of a 50-year-old obese female from Chennai who presented to the Department of Orthopaedics, SRIHER, Chennai, with complaints of bilateral hip pain and inability to weight bear on bilateral lower limb, following a high-velocity road traffic accident. She was diagnosed to have left acetabulum fracture with right hip displaced neck of femur fracture. We managed her with right hip bipolar hemiarthroplasty and left acetabulum open reduction and internal fixation. 6 month follow up showed excellent radiological and functional outcome. This case report highlights how obesity alters the surgical and medical management in obese patients with contralateral acetabulum and neck of femur fracture and the importance of a multidisciplinary approach in such polytrauma patients.


Acetabulum, Neck of femur, Obesity, Infection

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Sardesai NR, Miller MA, Jauregui JJ, Griffith CK, Henn RF, Nascone JW. Operative management of acetabulum fractures in the obese patient: challenges and solutions. Orthopedic research and reviews. 2017;9:75-81.

Porter SE, Graves ML, Maples RA, Woodall J Jr, Wallace JG, Russell GV. Acetabular fracture reductions in the obese patient. J Orthop Trauma. 2011;25(6):371-7.

Gettys FK, Russell GV, Karunakar MA. Open treatment of pelvic and acetabular fractures. Orthop Clin North Am. 2011;42(1):69-83.

Lee JB, Winstead PS, Cook AM. Pharmacokinetic alterations in obesity. Orthopedics. 2006;29:984e8.

Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;(305):112-23.

Rosell S, Belfrage E. Blood circulation in adipose tissue. Physiol Rev. 1979;59:1078e-4.

Armstrong D, Bortz P. An integrative review of pressure relief in surgical patients. AORN J. 2001;73:645e53.

Gong EM, Orvieto MA, Lyon MB. Analysis of impact of body mass index on outcomes of laparoscopic renal surgery. Urology. 2007;69:38e43.

Canturk Z, Canturk NZ, Cetinarslan B. Nosocomial infections and obesity in surgical patients. Obes Res. 2003;11:769e75.

Uppot RN. Impact of obesity on radiology. Radiol Clin North Am. 2007;45(2):231-46.