Diagnosis and management of a superior gluteal artery lesion following intramedullary fixation of a diaphyseal femoral fracture: a case report

Clin Ter. 2022 Nov-Dec;173(6):520-523. doi: 10.7417/CT.2022.2474.

Abstract

Introduction: Femur fractures represent a major public health issue and are commonly treated by intramedullary nailing. Among the possible complications of this technique, the injury of the superior gluteal artery (SGA) is quite rare, but it must be promptly recognized and treated.

Case report: A 35-year-old male was admitted with a right femur diaphyseal fracture. After an early damage control surgery, he under-went a close reduction and long intramedullary nail fixation. During the post-operative rehabilitation, a sudden hip pain and hemoglobin drop occurred. A CT-scan showed an extensive hematoma; angiography confirmed a superior gluteal artery bleeding which was subsequently treated with selective embolization.

Discussion and conclusion: Whenever a patient presents with postoperative suspect of active bleeding, it is important to consider even the rarest complications. Sharing our experience in the management of a SGA lesion case, we want to stress the importance of its early diagnosis and correction, since it can represent a life-threatening condition.

Keywords: Superior gluteal artery; inter-ventional radiology; intramedullary nailing.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bone Nails / adverse effects
  • Femoral Fractures* / diagnostic imaging
  • Femoral Fractures* / etiology
  • Femoral Fractures* / surgery
  • Femur
  • Fracture Fixation, Intramedullary* / adverse effects
  • Fracture Fixation, Intramedullary* / methods
  • Humans
  • Iliac Artery
  • Male
  • Postoperative Complications / etiology