Femoral Nerve Palsy Associated with an Associated Posterior Wall Transverse Acetabular Fracture

A case is presented of a patient who sustained bilateral acetabular fractures in a motor vehicle crash. On the right, he sustained a variant associated posterior wall transverse fracture, with a femoral nerve lesion noted preoperatively. Open reduction and internal fixation of both fractures was performed in a staged fashion with an ilio-inguinal approach on the right. At surgery, the femoral nerve was 90% divided and damaged over ∼5 cm of length, with marked damage also of the ilio-psoas muscle and tendon and the inguinal canal. No attempt was made to repair the nerve, and at 11-month follow-up he has had no recovery and eletrodiagnostic tests indicate no femoral nerve function.