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Unusual presentation of more common disease/injury
CASE REPORT
Bilateral acetabular fractures induced by an epileptic seizure in a paediatric patient: a unique case and its management
  1. Nusrat Mohamed1,
  2. Stanislau Makaranka2,
  3. Kamalpreet Cheema3 and
  4. Paul Harnett4
  1. 1 Orthopaedics, King’s College Hospital NHS Foundation Trust, London, UK
  2. 2 Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
  3. 3 Orthopaedic Surgery, King’s College Hospital NHS Foundation Trust, London, UK
  4. 4 Trauma & Orthopaedic Surgery, King’s College Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Stanislau Makaranka, stanislau.makaranka{at}nhs.net

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.

  • orthopaedics
  • paediatrics

https://doi.org/10.1136/bcr-2019-230143

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    Footnotes

    • Contributors NM is the foundation year 1 doctor. SM is the foundation year 2 doctor. KC is the orthopaedic registrar and PH is the consultant orthopaedic surgeon. All authors contributed to the planning and reporting of this case report. NM and SM led equally in the construction of case summary and literature review, including the obtaining and review of the patient’s clinical notes and imaging. KC contributed with suggestions for improvement of the case report and operative details, while PH supervised the project, contributing operative details and further comments/suggestions for improvement.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.