In elderly individuals, low-energy trauma can cause acetabular fractures. Many surgical options have been described, including open reduction and internal fixation (ORIF), arthroplasty, and combined hip procedure. We present a 74-year-old man with a fall-related acetabular fracture with an unusual pattern, which was managed by ORIF and total hip arthroplasty. The patient experienced a hip dislocation at three weeks postoperation that was reduced in the emergency department. At 12 months post-operation, the patient resumed the same level of function he had before falling, using a cane while outside his home and sometimes inside. The combined hip procedure is associated with early weight bearing and excellent Harris hip scores, but proper preoperative planning and patient optimization are needed.
