Background. To evaluate factors associated with gluteal muscle necrosis following transcatheter arterial embolization (TAE) for pelvic fracture.
Method. TAE was performed in the treatment of hemorrhagic shock caused by pelvic fracture in 131 patients between 2001 and 2007. Forty patients died during the first 24 h after trauma. Among the remaining 91 patients, patients who suffered gluteal muscle necrosis were evaluated for age, gender, ISS, embolic sites, muscle necrosis sites, treatment and clinical outcomes.
Results. Gluteal muscle necrosis occurred in 5 patients. Three patients, including 1 patient with rectal injury, underwent TAE of bilateral internal iliac arteries using gelatin sponge particles and steel coils. One of the remaining 2 patients underwent TAE of both right inferior gluteal and left internal pudendal arteries. The remaining elderly patient with severe arteriosclerosis and sigmoid injury underwent TAE of the right superior and inferior gluteal arteries.
Conclusions. Gluteal muscle necrosis warrants more attention as a complication in patients with pelvic fracture who have undergone TAE of bilateral internal iliac arteries or gluteal arteries.

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Purpose: Most distal radial fractures can be stabilized with a volar locking plate system, whereas secondary loss of reduction has also been reported. Close placement of the distal screws to the joint is essential to prevent loss of reduction in a cadaveric model, but it is still not clearly demonstrated in clinical settings.
Method: We investigated the importance of the screw position with 40 cases who underwent volar plating for unstable distal radial fractures. The screw position was evaluated by standard X-ray intra-operatively and 6 weeks after surgery, as well as by intra-operative computed tomography (CT).
Results: The distance from the subchondral zone to the most distal screw on a standard X-ray lateral view was validated as a good indicator to show the screw position by an assessment with X-ray and CT. Loss of volar tilt, ulnar variance, and radial inclination 6 weeks after surgery were moderately correlated with the screw position. Secondary loss of reduction was significantly low when the distal screws were placed within 2 mm of the joint on X-ray lateral view.
Conclusions: Close placement of distal screws within 2 mm of the subchondral zone is recommended to prevent secondary loss of reduction in clinical cases of volar locking plate fixation for distal radial fracture.

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