TY - JOUR T1 - Superior gluteal artery pseudoaneurysm following intramedullary nailing of an atypical femoral fracture JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-231490 VL - 12 IS - 10 SP - e231490 AU - Nikhil Ailaney AU - Robert O’Connell AU - Laura Giambra AU - Gregory Golladay Y1 - 2019/10/01 UR - http://casereports.bmj.com/content/12/10/e231490.abstract N2 - A 79-year-old woman with a history of osteoporosis treated with alendronate presented to the orthopaedic clinic with persistent left hip pain. X-ray and bone scan revealed an atypical femoral fracture associated with bisphosphonate use. The fracture was repaired with antegrade femoral intramedullary fixation. Her postoperative course was complicated by acute blood loss anaemia requiring several packed red blood cell transfusions and progressive thigh ecchymosis. CT angiography demonstrated extravasation of contrast from the superior gluteal artery (SGA). Subsequent angiography revealed an SGA pseudoaneurysm above the intramedullary nail, which was coil embolised. Iatrogenic SGA injury secondary to femoral intramedullary fixation is a rare complication, with only one previous case reported in the literature. Therefore, successful identification of the injury required attention to patient reported symptoms, neurovascular examinations and laboratory values to determine the cause of the patient’s postoperative anaemia. The patient made a full recovery and did not have any long-term adverse effects following the embolisation. ER -