ArticleFrontiers in surgery2026
Case Report: Life-saving external hemipelvectomy after missed external iliac artery occlusion in severe pelvic trauma.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
External hemipelvectomy is a radical procedure traditionally reserved for advanced malignancy, with its use in trauma being exceedingly rare. We report a 15-year-old female with severe pelvic trauma complicated by a missed external iliac artery occlusion following internal iliac artery embolization, resulting in irreversible limb ischemia and progressive soft-tissue necrosis. Despite fasciotomy, above-knee amputation, and repeated debridement, the infection advanced proximally with recurrent sepsis, ultimately necessitating a life-saving external hemipelvectomy. Reconstruction was achieved using a deep inferior epigastric artery perforator flap, followed by staged wound management and rehabilitation, leading to complete wound healing. At 28 months of follow-up, the patient was able to ambulate independently with a customized hemipelvic prosthesis. This case highlights a critical diagnostic pitfall in pelvic trauma and demonstrates that timely recognition, multidisciplinary management, and advanced reconstructive strategies can achieve meaningful functional recovery even after radical limb-sacrificing procedures.
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