Atypical anterior wall fracture extending to anterior inferior iliac spine with preservation of pelvic brim: A case report and literature review.

KEY CLINICAL MESSAGE: Anterior acetabular wall fractures that extend into the anterior inferior iliac spine are more likely to be unstable, and more likely to require surgical fixation.

ABSTRACT: Conventional acetabular anterior wall fractures originate below the anterior inferior iliac spine (AIIS) level and involve the pelvic brim. Since surgical treatment is preserved for instability and hip incongruency, atypical variation of this fracture usually jeopardizes hip stability. We report on a 33-year-old case of an acetabular anterior wall fracture extending to the anterior inferior iliac spine. He was prepared for the stress test and hip stability checked, that was unstable in extension and external rotation. The joint was exposed with the Smith-Peterson approach. Hip congruency was restored, and the AIIS fragment was stabilized by open reduction. Acetabular anterior wall fracture involving AIIS with preservation of pelvic brim is a rare equivalent of anterior wall fracture that jeopardizes hip stability and should be managed surgically. Anterior approaches are preferred in order to visualize the joint.