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Background: Pediatric acetabular fractures are rare, typically only resulting from a high-energy trauma. The same applies to pediatric proximal femoral fractures. The combination of both fractures is exceptionally uncommon and carries a high risk of complications, including avascular necrosis, nonunion, coxa vara, and premature physeal closure. Case presentation: An 11-year-old female patient presented with severe right hip pain following a fall down stairs. There was no gross limb shortening or rotational deformity. Anteroposterior, lateral, and Lowenstein projection radiographs revealed a proximal epiphysiolysis fracture of the right femur with severe displacement, associated with a fracture of the ipsilateral posterior acetabular wall. A posterior surgical approach to the right hip was used to carefully reduce both the femoral epiphysiolysis and acetabular fracture.  Fixation of the acetabulum was achieved using a small reconstruction plate and screws, while the femoral neck was stabilized with a 7.0-mm partially threaded cannulated screw. Although satisfactory reduction and fixation were achieved, follow-up assessments revealed signs of articular deformity and secondary osteoarthritis. Conclusion: Although rare, the pathology presented in this case report highlights the clinical importance of this injury. The post-operative complications following both isolated fractures are high. When these fractures occur in association, we postulate that the risk of complications is significantly increased and may lead to more severe functional impairment.

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