# Management of complete intra-articular distal femur and patellar fractures in an achondroplastic young adult; small is challenging’ revisited: a case-report

## TL;DR

This case report discusses the surgical challenges of treating fractures in a young adult with achondroplasia, highlighting the lack of existing guidance for such rare cases.

## Contribution

The paper contributes a detailed case report on managing complex fractures in an achondroplastic patient, emphasizing surgical and anesthetic challenges in resource-limited settings.

## Key findings

- Achondroplastic patients face unique surgical challenges due to anatomical variations and lack of suitable implants.
- Facial and spinal deformities in achondroplasia complicate anesthetic management.
- Limited literature forces surgeons to make independent decisions in managing such cases.

## Abstract

People with achondroplasia exhibit distinct physical characteristics, but their cognitive abilities remain within the normal range. The challenges encountered during surgical procedures and perioperative care for achondroplastic individuals, are underrepresented in the existing literature.

In this report, the management of a 26-year-old North-African achondroplastic male is highlighted. The patient suffered a complete intra-articular distal femur fracture (AO/OTA 33-C1) and an ipsilateral patella fracture (AO/OTA 34-C1). The patient’s unusual anatomical variations and the lack of suitable orthopedic implants posed significant surgical challenges, particularly in the context of a resource-limited developing country. Facial and spinal deformities, which are common in patients with achondroplasia, further complicated the anesthetic approach.

The limited information on operative management of fractures in achondroplastic patients necessitated independent decision-making and diverging from the convenient approach where clear guidance is available in the literature.