Superior Gluteal Artery Injury After Cephalomedullary Nailing of a Hip Fracture in a Patient on Anticoagulation: A Case Report and Literature Review.

INTRODUCTION

Saddle syndrome is caused by post-traumatic adhesions between the interosseous and lumbrical tendons and the intermetacarpal ligament in the webspaces of the hand. Diagnosis can be challenging, requiring a high index of suspicion with inadequately defined diagnostic criteria.

CASE REPORT: We present a case of saddle syndrome secondary to repetitive motorcycle use in a 56-year-old female to highlight the pathoanatomy, workup, diagnostic magnetic resonance imaging findings, and a new surgical approach for this disorder. Given persistent symptoms, surgical intervention was pursued using a commissural approach that provided superior en face visualization of the pathological anatomy. The adhesions between the intrinsic tendons and the intermetacarpal ligament were released with partial ligament resection.

CONCLUSION

Immediate post-operative mobilization led to complete pain resolution and return to full function by 3 months. This report provides the first high-quality in vivo photographs correlating with advanced imaging findings and demonstrates how a commissural surgical approach offers improved anatomical visualization for treating this condition.

LEVEL OF EVIDENCE: V.