A study of fresh cadavera was performed to assess the collateral circulation to the abductor muscle flap created by the various pelvic exposures in the presence of an occlusive injury to the ipsilateral superior gluteal artery. Through a bilateral extended iliofemoral, extended triradiate, modified extensile, or combined ilioinguinal and posterior approach, the right superior gluteal artery was occluded and an arteriogram was made. After use of the extended iliofemoral, the extended triradiate, and the modified extensile approaches, no angiographic evidence of circulation to the abductor muscles was demonstrated on the side of the occluded superior gluteal artery. There was circulation to the abductor muscles, despite occlusion of the superior gluteal artery, in cadavera in which the combined ilioinguinal and posterior approach had been used.
After completion of the extended iliofemoral, extended triradiate, and modified extensile exposures, a Microfil injection study was performed on the cadavera to assess the presence of microcirculation.No evidence of Microfil circulation was observed in the abductor muscles macrosurgically or microsurgically.
Preoperative assessment of the superior gluteal artery is recommended for a patient who is a candidate for an extensile exposure for an acetabular procedure.If the superior gluteal artery is occluded, a combined ilioinguinal and posterior operative approach should be considered.