[Vascular complication in pelvic ring stabilization : Case report of an iatrogenic injury to the superior gluteal artery].

Abstract

The superior gluteal artery is particularly at risk in pelvic fractures and surgical procedures. We report on a 74-year-old male patient with an unstable pelvic ring fracture, initially treated with an external fixator and bilateral sacroiliac (SI) screws. Postoperatively, persistently elevated inflammatory markers and a persistently low hemoglobin level suggested a hematoma most likely from an iatrogenic cause. Computed tomography (CT) imaging confirmed a 2 × 3 cm pseudoaneurysm of the superior gluteal artery. Hemostasis was successfully achieved through thrombin injection, hematoma evacuation and ligation. This case highlights that careful preoperative planning, detailed knowledge of vascular anatomy and early attention to laboratory parameters are essential for the prevention and detection of vascular injuries during SI screw implantation.