Abstract:
An 18-year-old male subject was referred to our MRI scanning center, by an orthopedic surgeon, for a swelling over the plantar region of the foot. He had been in a motor vehicle accident a few weeks back, with no evidence of fracture at the time of injury. In subsequent weeks, he developed a swelling over his foot. MRI showed the presence of a fluid intensity lesion in the subdermal and dermal layers of his foot. Unguarded motor vehicle accidents often tend to cause severe injuries. Sometimes, they even need operative management since a motor vehicle collision is a high-impact accident. One of the pathologies caused by a high impact force is the Morel-Lavallée lesion or a closed type of degloving injury. A Morel-Lavallee lesion also needs operative intervention if major vascular channels are involved in the degloving. However, if the major vessels supplying the region of degloving are intact, open surgery may not be needed. In such cases, incision and drainage along with serial wound dressing may be attempted. The primary risk in closed degloving is recurrent or subsequent tissue necrosis. Close and watchful monitoring is needed to anticipate and prevent these. Closed degloving injuries or Morel-Lavallée lesions have been commonly described in the thigh and pelvis region. Here, we describe a case that developed in the dermal and fascial layers of the foot and was managed conservatively. The epidermal layer showed regeneration, and the patient did not need subsequent amputation.
摘要:
一名18岁的男性受试者被转诊到我们的MRI扫描中心,由整形外科医生,足底区域肿胀。几周前他出了车祸,受伤时没有骨折的证据。在接下来的几周里,他的脚出现了肿胀。MRI显示他的脚的皮下和真皮层中存在流体强度病变。无人看守的机动车事故往往会造成严重伤害。有时候,他们甚至需要操作管理,因为机动车碰撞是一种高影响的事故。由高冲击力引起的病变之一是莫雷尔-拉瓦莱病变或闭合性脱套伤。如果脱套中涉及主要血管通道,则Morel-Lavallee病变也需要手术干预。然而,如果提供脱套区域的主要船只完好无损,可能不需要开放手术。在这种情况下,可以尝试切开和引流以及连续伤口敷料。闭合脱套的主要风险是复发性或随后的组织坏死。需要密切和警惕的监测来预测和防止这些情况。在大腿和骨盆区域通常描述了闭合性脱套伤或Morel-Lavalée病变。这里,我们描述了一个在足部真皮和筋膜层发展并保守治疗的病例。表皮层显示再生,患者不需要随后的截肢手术。