Closed Internal Degloving of the Flank

Abstract

Originally described in 1853 by Dr. Morel-Lavellee, closed internal degloving injuries represent an important, although<br />uncommon, source of morbidity in trauma patients. These injuries are typically the result of a shearing or crushing force that<br />traumatically separates the skin and subcutaneous tissue from the underlying fat. This results in disruption of perforating<br />blood vessels and lymphatics, leading to hematoma/seroma formation. We describe two cases in which industrial crush<br />injuries resulted in lumbar transverse process fracture. Both patients developed closed degloving injuries of the flank. To<br />the author's knowledge, this is the first case series describing the occurrence of closed internal degloving injuries of the<br />flank with transverse process fractures. We advise that a high level of suspicion for these lesions to occur with transverse<br />spinal fractures should be maintained, as they may arise several years after initial injury.