Closed Internal Degloving of the Flank

Document Type : CASE REPORT


Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, Ohio, USA


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


1. Morel-Lavallée AF. Décollements traumatiques de
la peau et des couches sous jacentes. Arch Gen Med.
1863; 9(1):20-38.
2. Hak DJ, Olson SA, Matta JM. Diagnosis and management
of closed internal degloving injuries associated with
pelvic and acetabular fractures: the Morel-Lavallee
lesion. J Trauma. 1997; 42(6):1046-51.
3. Mellado JM, Perez del Palomar L, Diz L, Ramos A,
Sauri A. Long-standing Morel-Lavallée lesions of
the trochanteric region and proximal thigh: MRI
features in five patients. AJR Am J Roentgenol. 2004;
4. Chokshi FH, Jose J, Clifford PD. Morel-Lavellee lesion.
Am J Orthop. 2010; 39(5):252-3.
5. Nickerson TP, Zeilinski MD, Jenkins DH, Schiller HJ. The
Mayo Clinic experience with Morel-Lavallee lesions:
establishment of a practice management guideline. J
Trauma Acute Care Surg. 2014; 76(2):493-7.