Anatomic considerations in penetrating gluteal wounds
D. W. Mercer, R. F. Buckman Jr, R. Sood, T. M. Kerr and J. Gelman
Department of Surgery, Temple University School of Medicine, Philadelphia, Pa.
A retrospective study of 81 patients with penetrating gluteal wounds was
performed to determine if the site of penetration was useful in predicting
the likelihood of associated vascular or visceral injury. There were 53
gunshot wounds and 28 stab wounds, including one impalement. The gluteal
region was divided into upper and lower zones by determining whether entry
occurred above or below the greater trochanters. Sixty-six percent of all
penetrating gluteal wounds entered the upper zone. Thirty-two percent of
patients with upper zone penetration had associated vascular or visceral
injury. Only one of 27 patients with lower zone penetration sustained major
injury. The site of entry plays a critical role in determining the
likelihood of serious injury associated with penetrating gluteal wounds.
Wounds penetrating above the greater trochanters demand thorough
evaluation, especially gunshot wounds.
