Management of a complex acetabular fracture following defibrillation for ventricular fibrillation cardiac arrest

BMJ Case Rep. 2023 Jul 10;16(7):e253421. doi: 10.1136/bcr-2022-253421.

Abstract

In this case report, we describe the first case of a patient who sustained a complex acetabular fracture following defibrillation for ventricular fibrillation cardiac arrest in the context of acute myocardial infarction. The patient was unable to undergo definitive open reduction internal fixation surgery due to the need to continue dual antiplatelet therapy following coronary stenting of his occluded left anterior descending artery. Following multidisciplinary discussions, a staged approach was opted for, with percutaneous closed reduction screw fixation of the fracture performed while the patient was maintained on dual antiplatelet therapy. The patient was discharged with a plan to perform definitive surgical management when safe to discontinue dual antiplatelets. This is the first confirmed case of defibrillation causing an acetabular fracture. We discuss the various aspects that need to be considered when patients are being worked up for surgery while on dual antiplatelet therapy.

Keywords: Cardiovascular medicine; Drug therapy related to surgery; Interventional cardiology; Ischaemic heart disease; Orthopaedic and trauma surgery.

Publication types

  • Case Reports

MeSH terms

  • Heart Arrest* / etiology
  • Heart Arrest* / therapy
  • Hip Fractures*
  • Humans
  • Myocardial Infarction*
  • Platelet Aggregation Inhibitors
  • Spinal Fractures*
  • Ventricular Fibrillation / etiology
  • Ventricular Fibrillation / therapy

Substances

  • Platelet Aggregation Inhibitors