Herein, is the described the case of a 60-year-old male with osteogenesis imperfecta (OI), presenting with an acetabulum fracture after low-energy trauma. Due to poor bone quality, the fracture configuration was unusual from a typical type of acetabulum fracture. This patient had severe impaction of articular on the femoral head and acetabulum, which was an unusual configuration pattern within the normal population. Definitive management required both fixation of the acetabulum, together with total hip replacement, with concerns in the quality of fixation.

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Early internal fixation of rib fractures in the setting of flail chest has proven benefits over traditional conservative treatment. This can decrease pneumonia, time on mechanical ventilation, length of stay in intensive care units, need for tracheostomy and increase in the pulmonary function test. However, there are few reports regarding on how to restore the costochondral junction, or costal cartilage in cases of anterior or anterolateral flail chest involving cartilage matrix of the ribs or costochondral joint. This case report describes a surgical technique to restore the costochondral junction with plate osteosynthesis and the results.