Hip Pelvis.  2017 Jun;29(2):145-149. 10.5371/hp.2017.29.2.145.

Superior Gluteal Artery Pseudoaneurysm Caused by Pelvic C-Clamp Blind Application: A Case Report

• Kim WY
• Lee SW
• Kim KS
• Lee JY

• KMID: 2424244
• DOI: http://doi.org/10.5371/hp.2017.29.2.145

Abstract

To control such a hemorrhage, a displaced pelvic ring must be rapidly reduced and stabilized with a pelvic binder, an external fixator, or a pelvic clamp. Among them, pelvic clamps can be life-saving but pin malposition may cause vascular complications. We present a case of superior gluteal artery pseudoaneurysm caused by AO pelvic C-clamp pin malposition.

Keyword

Pelvis; Fracture; Complication; Superior gluteal artery; Pseudoaneurysm

MeSH Terms

Aneurysm, False*
Arteries*
External Fixators
Hemorrhage
Pelvis

Figure

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  Fig. 1 Initial X-ray (A) and computed tomography (B) of the patient show diastasis of symphysis pubis and right sacroiliac joint.

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  Fig. 2 The vital signs were presented in graph in chronological order. Transfusion record was also inserted (systolic blood pressure [mmHg]/diastolic blood pressure [mmHg]/heart rate [beats/minute]). PAD: post-accident days, PRC: packed red cells, FFP: fresh frozen plasma, Pc: platelet concentrate.

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  Fig. 3 (A) Emergency pelvic C-clamp was applied with the blind method. (B) Blind application of pelvic C-clamp was done in emergency room.

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  Fig. 4 Open reduction and internal fixation for diastasis of symphysis pubis and fracture of pubic rami were achieved through an ilioinguinal approach using fourteen-hole 4.5-mm pelvic reconstruction plate (A, D) and screws. The diastasis of right sacroiliac joint was reduced and fixed with two sacroiliac screws tightly locked over the sacrum (A-D).

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  Fig. 5 Angiography of the common iliac artery, internal and external right iliac, and its branches was performed through the right femoral artery to trace internal hemorrhage. (A) Pseudoaneurysm of left superior gluteal artery was found. (B) Embolization was done.

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  Fig. 6 A pseudoaneurysm of left superior gluteal artery was observed (arrow), on abdominal contrast computed tomography (CT) just before surgery, just after removal of pins of pelvic C-clamp (A). (B) It is a finding that was not found in pelvic CT (arrow) checked in emergency department before pin insertion.

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