The gluteus maximus superior split muscle flap for complex posterior pelvic wounds

Coverage of complex posterior-lateral pelvic wounds can be difficult with currently described flaps. Using a superior transposition of the superior portion of the gluteus maximus, coverage can be obtained without resorting to free tissue transfers. No functional deficits are seen in ambulatory patients. We present a cadaver dissection and 2 patient reports to illustrate this versatile flap. Coverage of wounds involving the deeper aspects of the sacroiliac joint, or the posterior iliac crest, can be difficult without resorting to free tissue transfers. After trauma, osteomyelitis of these two areas can be treated by adequate and extensive debridement, but in doing so, significant dead space can be created. We have found the superior split gluteus muscle rotation flap to be an excellent choice in 2 patients whom we have encountered. To our knowledge, the superior rotation of this muscle flap has not been previously reported.