PMC4478406_01
Initial radiographs of the fracture sites. (a) An anteroposterior pelvic radiograph showing an AO type B3 fracture of the right acetabulum and AO type C3 fracture of the right femoral neck. (b) An anteroposterior radiograph showing an AO type A3 fracture of the right femoral shaft with a Gustilo type 2 open wound.
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Radiographs showed fractured femoral neck and shaft, an acetabular fracture (Figures 1(a) and 1(b)), and a humeral shaft fracture on the right side.
Three-dimensional computed tomography images showing a transverse fracture and posterior wall fracture of the right acetabulum.
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AO classification system (Figure 2). Additionally, her injury severity score was 29.
A postoperative radiograph of the femur. Retrograde intramedullary nailing for the right femoral shaft fracture and multiple cannulated cancellous screw fixation for the femoral neck fracture are performed.
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Then, she was placed on a traction table and underwent multiple screw fixation with cannulated cancellous screws for the right femoral neck fracture (Figure 3).
A postoperative radiograph of the acetabulum. Anterior and posterior plate fixation is performed.
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Then, using the Kocher-Langenbeck approach, posterior wall fixation was performed with a reconstruction plate (Figure 4).
Radiographs of the right femur after the first two operations and after arthroplasty. (a) At 15 weeks after the first two operations, the screws at the femoral neck are loose with nonunion of the femoral neck and shaft. (b) A radiograph showing that arthroplasty was successfully performed.
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Radiographs showed hypotrophic nonunion of the right femoral shaft and screw loosening of the right femoral neck (Figure 5(a)).
Anteroposterior radiographs of the pelvis (a) and femur (b) 1 year after arthroplasty.
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Additionally, radiographs demonstrated good callus formation in the pelvis and femur, and no loosening of the prosthesis was noted (Figure 6).