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The superior gluteal artery in complex acetabular procedures. A cadaveric angiographic study
P J Juliano1, M J Bosse, K J Edwards
1Department of Orthopaedic Surgery, National Naval Medical Center, Bethesda, Maryland 20889-5600.
The Journal of Bone and Joint Surgery. American Volume
|February 1, 1994
Summary
This study evaluated collateral circulation to abductor muscle flaps after superior gluteal artery occlusion. The combined ilioinguinal and posterior approach preserved blood flow, unlike other methods.
Area of Science:
- Anatomy
- Vascular Surgery
- Surgical Approaches
Background:
- The superior gluteal artery is crucial for abductor muscle flap viability.
- Pelvic exposures can compromise this artery, necessitating evaluation of collateral circulation.
Purpose of the Study:
- To assess collateral circulation to the abductor muscle flap following ipsilateral superior gluteal artery occlusion.
- To compare the effectiveness of different pelvic surgical approaches in maintaining this circulation.
Main Methods:
- Fresh cadavera underwent various pelvic exposures (iliofemoral, triradiate, extensile, ilioinguinal/posterior).
- The superior gluteal artery was occluded, followed by arteriography and Microfil injection studies.
- Circulation to abductor muscles was assessed macroscopically and microscopically.
Main Results:
- Extended iliofemoral, extended triradiate, and modified extensile approaches showed no collateral circulation to abductor muscles after superior gluteal artery occlusion.
- The combined ilioinguinal and posterior approach demonstrated collateral circulation to the abductor muscles despite superior gluteal artery occlusion.
- Microfil studies confirmed a lack of microcirculation in abductor muscles with the first three approaches.
Conclusions:
- Preoperative assessment of the superior gluteal artery is vital for patients undergoing extensile acetabular procedures.
- If the superior gluteal artery is compromised, the combined ilioinguinal and posterior approach is recommended to ensure abductor muscle flap viability.