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Missed closed degloving injury of the sacro-gluteal region

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Abstract

Closed degloving injury is a significant soft tissue injury that is associated with a pelvic trauma in which the subcutaneous tissue is torn away from the underlying fascia, creating a cavity filled with hematoma and liquefied fat. It commonly occurs over the great trochanter but may also occur in the flank and lumbodorsal region. Direct crush injury to the pelvis or a high-speed motor crash are the most common mechanisms of injury. Closed degloving injuries are uncommon but significant injuries, and the diagnosis may be missed at the time of acute trauma. They may give rise to significant morbidity if they are not treated correctly. In this report, we describe a missed closed degloving injury of the sacro-gluteal region of a 51-year-old female patient. Although the necrotic plaques and the palpable fluid collection under the plaques were clinically considered as a lesion caused by traumatic event initially, a small incision to the necrotic plaque on the gluteal region showed abundant serosanginous fluid of 5 l flow, and postaspiration computed tomography images demonstrated a large air-filled cavity extending from the L3 to S2 vertebrae. This appearance suggested that it was a missed closed degloving injury.

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References

  1. Sterling A, Butterfield WC, Bonner R Jr, Quigley W, Marjani M (1977) Post-traumatic cysts of soft tissue. J Trauma 17:392–396. doi:10.1097/00005373-197705000-00012

    Article  CAS  PubMed  Google Scholar 

  2. Hudson DA (1996) Missed closed degloving injuries: late presentation as a contour deformity. Plast Reconstr Surg 98:334–337. doi:10.1097/00006534-199608000-00020

    Article  CAS  PubMed  Google Scholar 

  3. Hudson DA, Knottenbelt JD, Krige JE (1992) Closed degloving injuries: results following conservative surgery. Plast Reconstr Surg 89:853–855. doi:10.1097/00006534-199205000-00013

    Article  CAS  PubMed  Google Scholar 

  4. Shlamovitz GZ, Kulkarni RG, Lin E Swelling and pain in the back and hip of a 35-year-old man. http://master.emedicine.com/email/image/image94/image94answer.html

  5. Letts RM (1986) Degloving injuries in children. J Pediatr Orthop 6:93–97

    Google Scholar 

  6. Hak DJ, Olson SA, Matta JM (1997) Diagnosis and management of closed internal degloving injuries associated with pelvic and acetabular fractures: the Morel-Lavallée lesion. J Trauma 42(6):1046–1051. doi:10.1097/00005373-199706000-00010

    Article  CAS  PubMed  Google Scholar 

  7. Gilbert BC, Bui-Mansfield LT, Dejong S (2004) MRI of a Morel-Lavallée lesion. AJR Am Roentgenol 182:1347–1348

    Google Scholar 

  8. Vico PG (2000) Morel-Lavallée syndrome. Eur J Plast Surg 23:45–48. doi:10.1007/s002380050012

    Article  Google Scholar 

  9. Kottmeier SA, Wilson S, Born CT, Hanks GA, Iannacone WM, DeLong WG (1996) Surgical management of soft tissue lesions associated with pelvic ring injury. Clin Orthop Relat Res 329:46–53. doi:10.1097/00003086-199608000-00007

    Article  PubMed  Google Scholar 

  10. Kudsk KA, Sheldon GF, Walton RL (1981) Degloving injuries of the extremityes and torso. J Trauma 21:835–839. doi:10.1097/00005373-198110000-00002

    Article  CAS  PubMed  Google Scholar 

  11. Gray H (1985) Anatomy of the human body. The lymphatic system. Philadelphia, Lea and Febinger, pp 913-917

  12. Markman B (1989) Anatomy and physiology of adipose tissue. Clin Plast Surg 16:235–244

    CAS  PubMed  Google Scholar 

  13. Mir L, Mir Y, Novell AM (1950) Repair of necrotic cutaneous lesions secondary to tangential trauma over detachable zones. Plast Reconstr Surg 6:264–274

    Article  Google Scholar 

  14. Meara JG, Guo L, Smith JD, Pribaz JJ, Breuing KH, Orgill DP (1999) Vacuum-assisted closure in the treatment of degloving injuries. Ann Plast Surg 42:589–594

    Article  CAS  PubMed  Google Scholar 

  15. DeFranzo AJ, Marks MW, Argenta LC, Genecov DG (1999) Vacuum-assisted closure fort he treatment of degloving injuries. Plast Reconstr Surg 104:2145–2148

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Selma Sönmez Ergün.

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Sönmez Ergün, S., Erözgen, F., Akdemir, O.C. et al. Missed closed degloving injury of the sacro-gluteal region. Eur J Plast Surg 33, 41–44 (2010). https://doi.org/10.1007/s00238-009-0370-3

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  • DOI: https://doi.org/10.1007/s00238-009-0370-3

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