Author(s): Dr. Joana Almeida, André Pinho, Maria João Almeida, Nuno Telo Ramos, João Duarte Silva, Vitorino Veludo and António Sousa

Abstract: Morell Lavellè injury is associated with high-energy trauma. By itself, avulsion of the gluteus maximus is an extremely rare injury, and their association is extremely rare.Case report: A 21-year-old was victim of a car accident. On admission, he presented pelvic instability and a large hematoma in the right gluteal region. X-rays and computerized axial tomography (CT) were performed. He was diagnosed with a bilateral sacral wing fracture with dislocation of the left sacroiliac joint and underwent fixation of the sacroiliac joint with cannulated screws on the left. After discharge, he recurred due to fever with inflammatory signs on the posterior surface of the right buttock, with palpation of a gap. Faced with this situation, a CT scan was repeated where an extensive degloving lesion of the soft parts was identified, opting for debridement and surgical cleaning. During the surgery, detachment of the gluteus maximus from its ileal insertion was verified. After adequate mobilization and release, transosseous reinsertion was performed with a multifilament suture. To date, no incidents to report, with good clinical and imaging evolution. Discussion: The gluteus maximus is one of the external rotators and the most important extensor of the hip, playing a preponderant role in gait. In addition, it has functions as a global stabilizer of the pelvic ring. Diagnose is not easy, it might even go unnoticed. Form of repair is not consensual: we performed a transosseous reinsertion with Ethibond® and Vicryl®. With this case we intend to highlight the importance of soft tissue degloving injuries in the context of polytraumatized patients.

DOI: 10.22271/27078345.2023.v5.i1b.151

Pages: 95-98 | Views: 324 | Downloads: 121

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