Carroll Colin, Warren Michael, Nammour Michael, Taillac Heather, Mautner James
The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.
Department of Orthopedics, Ochsner Clinic Foundation, New Orleans, LA.
Ochsner J. 2020 Fall;20(3):339-342. doi: 10.31486/toj.19.0084.
Hip fracture is a common orthopedic condition that leads to many hospitalizations each year. Intertrochanteric femur fractures are commonly treated with cephalomedullary nail fixation. Superior gluteal artery bleed is a rare complication of cephalomedullary nail fixation, especially when the trochanteric approach is used. A 63-year-old male presented to the emergency department with a right intertrochanteric femur fracture after a fall from standing height. Cephalomedullary nail fixation was performed without any complications during the operation. The patient's postoperative course was complicated by decreasing hemoglobin levels despite blood transfusions. Superior gluteal artery bleed with a large hematoma was discovered on postoperative day 4. The bleed was embolized, and the patient was stabilized and discharged. We found only 1 published report of a superior gluteal artery bleed associated with nail placement. During the operative procedure, guidewire placement requires careful consideration because of the risk of vascular damage. Superior gluteal artery injury, although rare, should be considered in patients with unstable hemoglobin levels after nail placement.
髋部骨折是一种常见的骨科疾病，每年导致许多患者住院。股骨转子间骨折通常采用髓内钉固定治疗。臀上动脉出血是髓内钉固定的一种罕见并发症，尤其是在采用转子入路时。一名63岁男性因从站立高度跌倒后出现右股骨转子间骨折而就诊于急诊科。手术过程中进行了髓内钉固定，未出现任何并发症。尽管进行了输血，但患者术后病程因血红蛋白水平下降而变得复杂。术后第4天发现臀上动脉出血并伴有巨大血肿。出血部位进行了栓塞治疗，患者病情稳定后出院。我们仅发现1篇关于与髓内钉置入相关的臀上动脉出血的发表报告。在手术过程中，由于存在血管损伤风险，导丝置入需要仔细考虑。髓内钉置入后血红蛋白水平不稳定的患者应考虑到臀上动脉损伤，尽管这种情况罕见。
