A rare seizure: A case of seizure-induced central acetabular fracture-dislocation in a patient with chronic kidney disease and hepatitis-B.

UNLABELLED: Seizure induced fractures are uncommon and usually involve long bone fractures like proximal humerus, proximal femur, shoulder dislocations etc. These occur due to intense muscle contractions or may result from indirect trauma post-seizure episode in the patient. Acetabulum fracture with central head dislocation, as seen in this case, is very rare following a seizure episode. It was further complicated by the presence of Hepatitis-B and dialysis dependent CKD both of which impact the surgical outcomes as well as pose challenges in the management of patient in the perioperative period.

CASE: A 32-year-old male with a history of CKD and Hepatitis-B presented with severe hip pain following a generalised tonic-clonic seizure. Imaging revealed an anterior column fracture with central dislocation of the femoral head. The patient underwent open reduction and internal fixation (ORIF) via the Modified Stoppa's approach. Perioperative management focused on optimising renal and hepatic dysfunction while minimising infection risk. Postoperatively, the patient demonstrated stable fixation and uneventful wound healing and good functional outcome.

CONCLUSION: This case highlights the rare occurrence of seizure induced acetabulum fracture and the challenges of perioperative management of such injuries in patients with metabolic comorbidities and thus helps with understanding the interplay between seizure induced trauma, CKD complicating the bone quality thus affecting the fixation and perioperative risks in Hepatitis-B.