Abstract
We report a case of gluteal muscle necrosis (GMN) following transcatheter angiographic embolization (TAE) for unstable pelvic ring fracture. The patient, a 34-year-old woman, was injured by a fall from the 4th floor of a building. On arrival in the emergency room, she was in a hemodynamically unstable state. X-ray and CT scan demonstrated a vertically unstable pelvic ring fracture, AO 61-C1. At first, TAE was performed for arterial bleeding and the patient was then transferred to the operation room for application of an external fixator for the unstable pelvic ring fracture and treatment of the associated injuries. On day 5, her buttock skin appeared to be necrotic and GMN was diagnosed by MRI. The pelvic ring fracture was fixed with an ilio-sacral screw as a minimal invasive method and diverting colostomy was performed to prevent contamination. After the necrotic area had been demarcated, debridement of the necrotic tissues was performed on day 21, and the open wound was placed under negative pressure (vacuum-assisted closure: VAC therapy). On day 35, a split-thickness skin graft was placed on the wound. The skin subsequently healed with no evidence of infection. GMN following TAE is rare, but can be a potentially fatal complications. The focus of treatment for GMN is to prevent infection and subsequent sepsis. Colostomy and VAC therapy are considered to be useful methods for treatment of GMN.
