A 34-year-old motorcyclist has a pelvic ring injury with a left sacroiliac joint disruption and an iliac wing crescent fracture. He remains hypotensive despite pelvic binding and fluid resuscitation. Focused angiography is planned. Which arterial injury is the most likely source of persistent pelvic hemorrhage in this pattern?

• A Internal pudendal artery
• B Obturator artery
• C Superior gluteal artery ✓
• D Lateral sacral artery

Explanation

The superior gluteal artery, the largest branch of the internal iliac artery, exits the greater sciatic notch directly adjacent to the sacroiliac joint and the crescent fragment. Disruption of the posterior pelvic ring shears this vessel against bone, making it the most commonly injured artery in posterior ring injuries and a frequent target for embolization. The pudendal and obturator arteries are more often implicated in anterior ring and straddle injuries.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.