RESUMEN
Aims: To identify unanswered questions about the prevention, diagnosis, treatment, and rehabilitation and delivery of care of first-time soft-tissue knee injuries (ligament injuries, patella dislocations, meniscal injuries, and articular cartilage) in children (aged 12 years and older) and adults. Methods: The James Lind Alliance (JLA) methodology for Priority Setting Partnerships was followed. An initial survey invited patients and healthcare professionals from the UK to submit any uncertainties regarding soft-tissue knee injury prevention, diagnosis, treatment, and rehabilitation and delivery of care. Over 1,000 questions were received. From these, 74 questions (identifying common concerns) were formulated and checked against the best available evidence. An interim survey was then conducted and 27 questions were taken forward to the final workshop, held in January 2023, where they were discussed, ranked, and scored in multiple rounds of prioritization. This was conducted by healthcare professionals, patients, and carers. Results: The top ten included questions regarding prevention, diagnosis, treatment, and rehabilitation. The number one question was, 'How urgently do soft-tissue knee injuries need to be treated for the best outcome?'. This reflects the concerns of patients, carers, and the wider multidisciplinary team. Conclusion: This validated process has generated ten important priorities for future soft-tissue knee injury research. These have been submitted to the National Institute for Health and Care Research. All 27 questions in the final workshop have been published on the JLA website.
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Cartílago Articular , Luxación de la Rótula , Traumatismos de los Tejidos Blandos , Adulto , Niño , Humanos , Articulación de la Rodilla , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/terapiaRESUMEN
Morel-Lavallée lesions (MLLs) result from high-energy trauma causing separation of subcutaneous tissue from the underlying tissue, most commonly in the gluteal region or thigh.We report the case of a woman in her 40s with a fluctuant collection of the cervico-thoracic region following trauma. Further imaging identified an MLL. An orthoplastic approach resulted in non-operative management with a spinal brace. Three months from initial injury, the lesion completely resolved. She was symptom free at final follow-up and discharged.We present the only recorded case of MLL developing in the cervico-thoracic region. Management posed difficultly as no literature currently exists. We demonstrated conservative management for cervico-thoracic MLL can be effective.We have described the first documented case of cervico-thoracic MLL. MLL is not exclusive to pelvic injuries and can develop in the cervico-thoracic region. We have shown conservative management is a viable treatment of atypical MLL.
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Lesiones por Desenguantamiento , Traumatismos de los Tejidos Blandos , Femenino , Humanos , Traumatismos de los Tejidos Blandos/diagnóstico , Lesiones por Desenguantamiento/terapia , Lesiones por Desenguantamiento/patología , Muslo/patología , Dorso/patología , Torso/patologíaRESUMEN
The facial trauma surgeon will see a variety of facial injuries. Recognition of emergency cases and proper intervention is and this article aims to highlight those cases and the respective proper interventions.
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Traumatismos Faciales , Traumatismos de los Tejidos Blandos , Humanos , Traumatismos Faciales/diagnóstico , Traumatismos Faciales/cirugía , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugíaRESUMEN
Pediatric trauma has been affected by COVID-19, school closures, and stay at home advice. Health seeking behavior has decreased. The aim of this study is to assess trends in the presentation of maxillofacial soft tissue injuries and subsequent management within a regional pediatric hospital. Retrospective study over a 3-year period (from 2019 to 2021 between the months of January and April). Inclusion of all pediatric patients seen by Oral and Maxillofacial Surgery team. Between 2019 and 2021, the total number of patients dropped by over half. The average age dropped from 5.9 in 2019 to 3.8 in 2021. Males were more commonly seen. Falls are the most common cause of injuries across 2019 to 2021. Extraoral injuries increased by 21%. Intraoral injuries reduced by 8%. Lip lacerations accounted for most injuries. In 2020, there was 21% reduction in conservative management of injuries. Wound closure under local anesthetic peaked in 2020, by 12%. Wound closure under general anesthetic has increased by 5%, and accounts for nearly a third of all injuries in 2020 and 2021. Patients are becoming younger and more likely to be male. Conservative management is most common but closure under local anesthetic and general anesthetic has increased. This may indicate an increase in the severity of soft tissue injuries or a trend toward operative management. We also introduce a laceration grading scale for clinician use to assist in assessing and documenting injury severity. Further research is needed to assess whether these trends continue or revert to prepandemic trends.
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Anestésicos Generales , COVID-19 , Laceraciones , Traumatismos Maxilofaciales , Traumatismos de los Tejidos Blandos , Niño , Humanos , Masculino , Femenino , Laceraciones/cirugía , Traumatismos Maxilofaciales/diagnóstico , Traumatismos Maxilofaciales/epidemiología , Traumatismos Maxilofaciales/cirugía , Estudios Retrospectivos , Hospitales Pediátricos , Anestésicos Locales , COVID-19/complicaciones , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugíaRESUMEN
BACKGROUND: Soft tissue injuries are a common consequence of head and neck trauma. With injuries being highly individual and varying depending on the underlying trauma, it is difficult to establish standardized guidelines for head and neck trauma in general. The main goal of this study was to showcase the distribution of soft tissue injury types and the principles pertaining to acute care of the individual clinical presentations. MATERIALS AND METHODS: A retrospective evaluation was carried out using all trauma-relevant ICD-10 codes for trauma to the head (S00.- to S09.-) and neck (S10.- to S19.-) among patients who were treated at the authors' clinic-a certified national trauma center-during a period of 10 years (2012 to and including 2021). RESULTS: A total of 8375 patients with head and neck trauma were treated during the observation period, i.e., an average of 836 patients per year. Within this collective, 2981 trauma cases involving soft tissue injuries were documented. Superficial injuries to the head (S00.-) and open wounds to the head (S01.-) were the most common head and neck soft tissue injuries, with 1649 and 920 cases, respectively. CONCLUSION: The case numbers of soft tissue injuries generally show an inverse correlation to the required underlying trauma: diagnoses of the categories S00 and S01 occur very often; injuries which only occur after severe trauma, such as traumatic amputation at neck level (S18), are rare. According to current literature, penetrating neck traumas should be treated using a no-zone approach. In Europe, penetrating neck injuries are rather rare because of low crime rates and strict weapon laws.
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Traumatismos del Cuello , Traumatismos de los Tejidos Blandos , Heridas Penetrantes , Humanos , Heridas Penetrantes/diagnóstico , Heridas Penetrantes/etiología , Heridas Penetrantes/terapia , Estudios Retrospectivos , Cuello , Traumatismos del Cuello/diagnóstico , Traumatismos del Cuello/epidemiología , Traumatismos del Cuello/terapia , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/epidemiología , Traumatismos de los Tejidos Blandos/terapiaRESUMEN
The treatment of the Cierny-Mader (C-M) type III-IV calcaneus osteomyelitis combining with the soft-tissue defect is sophisticated and difficult. The aim of this study is to introduce the application and availability of the modified distally based sural flap with an adipofascial extension to reconstruct these defects. We retrospectively reviewed the data of 37 patients with C-M type III-IV calcaneus osteomyelitis accompanied with soft-tissue defect between December 2004 and December 2019. A modified distally based sural flap with an adipofascial extension was conducted to reconstruct the defect. The patient's demographics, duration of the diseases, etiology, reconstruction outcomes, infection control rate, recurrence rate, amputation rate, and follow-up data were collected to evaluate the effectiveness and reliability of the modification. The American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot scale was applied to assess the function of the ankle and hindfoot. Thirty-four flaps survived uneventfully, 1 flap displayed marginal necrosis and 2 flaps (5.41%) developed partial necrosis. Using this modified flap alone or combining with some simple salvage methods reconstructed all of the defects successfully. The calcaneus osteomyelitis was cured successfully, and no recurrences were observed during the follow-up period. The AOFAS ankle and hindfoot scores were excellent in 27 patients and good in 8 patients. The distally based sural flap with an adipofacial extension is a simple and effective technique to reconstruct the calcaneus osteomyelitis combined with soft-tissue defect in 1 stage. Applications of the adipofacial extension to obliterate the dead space and the well-vascularized skin island to cover the defect are the guarantee of achieving good ankle and foot functions. However, this technique is not appropriate for the patients with calcaneum less than half weight-bearing area.
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Calcáneo , Osteomielitis , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos , Humanos , Calcáneo/cirugía , Estudios Retrospectivos , Reproducibilidad de los Resultados , Osteomielitis/diagnóstico , Osteomielitis/cirugía , Osteomielitis/etiología , Traumatismos de los Tejidos Blandos/complicaciones , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugíaRESUMEN
Reconstruction of soft tissue defects in the lower extremity due to different etiologies can be a challenging process for surgeons. Compelling reasons for reconstruction include the anatomy of the lower extremity, limited mobility of soft tissues especially the presence of bone, tendon, and neurovascular structures under the defect, and the exposed fixation materials make these defects more complicated. Local fasciocutaneous and muscle flaps are frequently used for the reconstruction of these defects. The patients in our study were with multiple comorbidities such as diabetes mellitus, hypertension, atherosclerosis, and peripheral vascular disease. In this study, with a clinic series consisting of 42 patients (29 male and 13 female), we present a reconstruction with a bipedicled flap as a safe, simple, and efficient reconstructive modality in the treatment of lower extremity soft tissue defects. Except for 1 total flap loss, all defects were successfully reconstructed without any major complications. When reconstruction is performed with a bipedicled flap, the main neurovascular structures are not damaged, free flap and other locoregional flaps can be used as a salvage protocol.
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Colgajos Tisulares Libres , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos , Humanos , Masculino , Femenino , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/etiología , Traumatismos de los Tejidos Blandos/cirugía , Extremidad Inferior/cirugía , Extremidad Inferior/lesiones , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The reconstruction of defects of the lateral malleolus involving the exposed fibular bone or tendon is challenging. This study aimed to evaluate the clinical application of the peroneal artery perforator flap with or without split-thickness skin grafting for soft tissue reconstruction of the bony defect of the lateral malleolus of the ankle joints. Reconstruction using a peroneal artery perforator flap with or without split-thickness skin grafting was performed for 15 patients (10 men, 5 women) between January 2007 and December 2018. The mean age was 53.7 years, and the mean size of the flaps was 40â cm2. The flaps were elevated in the form of a perforator flap, and split-thickness skin grafting was performed over the flaps and adjoining raw areas. The flaps survived in all cases; however, partial necrosis was observed in 3 cases. In cases of small-sized defects of the lateral malleolus of the ankle joints where a flap is required for the exposed bone or tendon, reconstruction using the peroneal artery perforator flap is advantageous, since the morbidity rate of the donor site is low and soft tissue is reconstructed.
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Colgajo Perforante , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos , Masculino , Humanos , Femenino , Persona de Mediana Edad , Colgajo Perforante/irrigación sanguínea , Articulación del Tobillo/cirugía , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugía , Trasplante de Piel , Arterias Tibiales/cirugía , Resultado del TratamientoAsunto(s)
Traumatismos de los Tejidos Blandos , Arterias/diagnóstico por imagen , Arterias/lesiones , Arterias/cirugía , Extremidades/lesiones , Extremidades/cirugía , Humanos , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/etiología , Traumatismos de los Tejidos Blandos/cirugíaRESUMEN
The anterolateral thigh flap is a classic flap used for various reconstruction defects. However, the flap viability of extended large skin paddles (ie, 240 cm2) was doubted by many surgeons. This study reports successful experience of reconstructing extensive soft tissue defects of lower extremity using extended large skin paddles. Twelve consecutive patients who had undergone reconstruction of defects using an extended anterolateral thigh flap were identified. Patient characteristics (age, sex, defect location, injured structures, and type of flap) and outcome data were analyzed retrospectively. One artery and 2 accompanying veins were anastomosed to vascularize each flap. Follow-up periods ranged from 10 to 91 months postoperatively. The average size of the flaps was 268.75 cm2 (range = 220-391 cm2). All flaps were perforator flaps with one perforator except that 2 perforators were used in 3 patients. Two patients suffered partial flap necrosis of the distal portion with delayed healing. In conclusion, the extended anterolateral thigh flap is a considerable option for massive defects requiring composite tissue coverage. This flap is advantageous for reconstructing various complex defects in the lower extremities, providing a pliable and vascularized tissue to cover exposed extensive defects including tendons, nerves, and bones.
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Colgajo Perforante , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos , Humanos , Colgajo Perforante/irrigación sanguínea , Muslo/cirugía , Estudios Retrospectivos , Extremidad Inferior/cirugía , Venas , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugía , Trasplante de Piel , Resultado del TratamientoRESUMEN
AIM: Accurate records of traumatic dental injuries are important for clinical management and data collection for research. Soft tissue injuries often accompany dental trauma and should be appropriately recorded. The Eden Baysal Dental Trauma Index (EBDTI) provides an easy recording system of useful information about traumatic dental injuries on a tooth basis. The aim of this study was to extend the EBDTI index to record soft tissue injuries in a concise format and to approve the face and content validity of this version as the modified EBDTI (MEBDTI). MATERIALS AND METHODS: An extension to EBDTI was developed by adding superscript numbers from 0 to 8 to represent soft tissue injuries related to dental trauma. The Rand e-Delphi method was used to evaluate this version of the index. A definition and two statements about the index were sent to 15 international panel experts to be assessed independently on a 9-point Likert scale where 1 represented "total disagreement," and 9 indicated "total agreement." The panel needed to reach a 75% consensus for validation. A numerical code was suggested using zero to depict no soft tissue injury; 1-4 to record extra-oral injuries; and 5-8 to record intra-oral injuries (for example, gingiva, frenulum, and palate). Traumatic dental injury of the tooth/teeth is recorded using EBDTI in square brackets, and soft tissue codes are used as superscript numbers outside the brackets on a patient basis. RESULTS: The panel reached a consensus on the definition (86.7%) and two statements (86.7% and 93.3%) in one round. Various cases are presented to demonstrate the application of the index. CONCLUSION: The Modified Eden Baysal Dental Trauma Index was developed to record soft tissue. injuries on a patient basis and was approved for face and content validity.
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Traumatismos de los Tejidos Blandos , Traumatismos de los Dientes , Consenso , Humanos , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Dientes/diagnósticoRESUMEN
Soft tissue injuries of the head and neck are a common reason for medical evaluation and treatment in pediatric populations with some unique and important considerations when compared with adults. The incidence and type of injuries continue to evolve with the adoption of new safety measures, technology advancements, and education of the general population. The goal of this article is to provide the reader with a thorough understanding of the evaluation and management of pediatric soft tissue trauma including the initial workup, physical examination, appropriateness of antimicrobial therapy, and setting for surgical repair. Additionally, the pediatric anesthetic considerations for evaluation and repair in regard to local anesthesia, sedation, and general anesthesia are described in detail. There is a focus on dog bites, perinatal injuries, and child abuse as these entities are distinctive to a pediatric population and have particular management recommendations. Lastly, application of the reconstructive ladder as it applies to children is supported with specific case examples and figures. Although there are many parallels to the management of soft tissue injury in adults, we will highlight the special situations that occur in pediatric populations, which are imperative for the facial plastic and reconstructive surgeon to understand.
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Anestesia , Mordeduras y Picaduras , Traumatismos Faciales , Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos , Adulto , Mordeduras y Picaduras/terapia , Niño , Traumatismos Faciales/cirugía , Traumatismos Faciales/terapia , Humanos , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/etiología , Traumatismos de los Tejidos Blandos/terapiaRESUMEN
Eyelid trauma occurs across a broad spectrum of pathology, ranging from simple periorbital lacerations to severe, vision-threatening injuries requiring expert oculoplastic consultation. Any injury, no matter how benign, is also inherently cosmetically sensitive, further adding to the reconstructive challenge. In this review, we discuss the anatomy of the eyelid and develop an understanding of evaluating for signs of more serious, potentially occult, trauma. A framework is developed for approaching the patient with periorbital trauma to assess for injury and triage necessary treatments. Damage to the lacrimal drainage system, which can be particularly difficult to detect and repair, is specifically emphasized and explored.
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Lesiones Oculares , Enfermedades de los Párpados , Laceraciones , Traumatismos de los Tejidos Blandos , Lesiones Oculares/diagnóstico , Párpados/lesiones , Párpados/cirugía , Humanos , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugíaRESUMEN
A Morel-Lavallée lesion is a post-traumatic, soft tissue lesion that is little known and for which there is no standard treatment. This report describes the case of a 51-year-old man who presented with a large Morel-Lavallée lesion on the left calf that was not diagnosed on two visits to the emergency department. Given the deteriorating condition of the skin, we performed surgical drainage of the effusion because the skin was showing signs of major damage. Complications occurred following surgery, with cellulitis in the lower limb caused by Citrobacter Koseri, a gram-negative bacillus that is rarely implicated in soft tissue infections, and wound dehiscence. The purpose of our article is to present the difficulty involved in choosing the right treatment from among the many proposed in the literature, and to inform any practitioner working in an emergency setting about the existence of this often overlooked condition.
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Traumatismos de los Tejidos Blandos , Humanos , Masculino , Persona de Mediana Edad , Traumatismos de los Tejidos Blandos/diagnósticoRESUMEN
BACKGROUND: Differential diagnosis of soft tissue swelling on exposed body parts in the young athlete is large and mostly includes benign self-limiting conditions, once underlying lesion to the bone, the cartilage, and the ligaments is excluded. Morel-Lavallée lesion represents a rare soft tissue injury requiring prompt intervention to ensure favorable outcome. CASES: A 10-year-old boy presented with 2-week-old swelling of the medial side of the knee without recent traumatic event. Unawareness of Morel-Lavallée lesion in the differential diagnosis led to delayed diagnosis and treatment. A 16-year-old boy came to our pediatric tertiary care center with a similar presentation and history. Timely intervention allowed for favorable outcome and early return to play. CONCLUSIONS: Morel-Lavallée lesion is a rare entity in the pediatric population, although underreporting due to unfamiliarity with the diagnosis is highly probable. Raising awareness among professionals in charge of young athletes should allow for better reporting as well as for elaboration of a standardized treatment plan, including rapid intervention and early return to play.
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Traumatismos en Atletas , Traumatismos de los Tejidos Blandos , Adolescente , Atletas , Traumatismos en Atletas/diagnóstico , Niño , Diagnóstico Diferencial , Edema , Humanos , Masculino , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/etiologíaRESUMEN
This was a prospective randomised controlled trial comparing the effects of first-degree perineal tear repair using adhesive glue versus conventional suturing in terms of pain score, wound complication and patient's satisfaction. One hundred and twenty one women were randomised. The skin adhesive group had a significantly lower pain score at rest as well as during sitting, walking and micturition during the first week of delivery compared to the suture group. The time taken to become pain free was significantly shorter in the tissue adhesive group (3.18 vs. 8.65 days, p < .001). Only two patients who had skin glue experienced wound gaping. No significant difference was observed in the level of satisfaction between the adhesive and suture groups. Tissue adhesive is better than subcuticular suture for repairing first-degree perineal tear as it causes less pain and has shorter recovery time.Impact statementWhat is already known on this subject. First- and second-degree tears following vaginal delivery are common and involved a third of women. Suturing of these tears is advocated to avoid wound gaping and poor healing.What the results of this study add. For first-degree tear repair, tissue adhesive is better than conventional suture in terms of pain reduction and recovery time.What the implications are of these findings for clinical practice and/or further research. Skin adhesive is an ideal method for first-degree perineal tear repair especially in out of hospital settings such as home birth or midwifery-led centre. A larger scale study is needed to establish its feasibility for second- and third-degree tears repair.
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Laceraciones , Parto Normal/efectos adversos , Complicaciones del Trabajo de Parto , Perineo/lesiones , Traumatismos de los Tejidos Blandos , Técnicas de Sutura , Adhesivos Tisulares/uso terapéutico , Adulto , Femenino , Humanos , Laceraciones/diagnóstico , Laceraciones/etiología , Laceraciones/fisiopatología , Laceraciones/terapia , Parto Normal/métodos , Complicaciones del Trabajo de Parto/diagnóstico , Complicaciones del Trabajo de Parto/fisiopatología , Complicaciones del Trabajo de Parto/terapia , Manejo del Dolor/métodos , Dimensión del Dolor/métodos , Embarazo , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/etiología , Traumatismos de los Tejidos Blandos/fisiopatología , Traumatismos de los Tejidos Blandos/terapia , Índices de Gravedad del Trauma , Resultado del Tratamiento , Cicatrización de Heridas/efectos de los fármacosRESUMEN
BACKGROUND: The management of traumatic composite bone and soft tissue loss (TCBSTL) requires a classification system and decision-making algorithm for the purpose of description, prognosis and choice of treatment method. PATIENTS AND METHODS: between the year 2000 and 2017 a series of 254 cases of TCBSTL were treated using distraction histogenesis and external fixation techniques. The tissue loss was due to either the initial injury or debridement of infection. Adjunctive procedures included split thickness skin grafting and ICBG when indicated. A classification system was designed by the author. The classification is based on factors that influence management and prognosis; (1) stability of the host bone (intact tibia or a well-fixed fracture), (2) presence or absence of infection in the fracture site, (3) size of bone defect, and (4) contamination (infection) of the medullary cavity. A flowchart and decision-making algorithm was subsequently developed. RESULTS: Ilizarov external fixator was used in all cases. Ten cases (4%) had combined Masquelet - Ilizarov technique. One hundred seventy five cases (68.9%) had gradual distraction-compression (GDC) technique; while 79 cases (31.1%) had acute shortening and re-lengthening (ASRL) technique. Seventy-two cases (28.3%) had autogenous iliac crest bone graft (ICBG). All cases (100%) had complete clinical and radiological fracture union. All patients completed the follow up that ranged from 24 to 118 months (mean 43.3 ± 23). The results were satisfactory in 212 cases (83.5%) and unsatisfactory in 42 (16.5%) cases due to residual leg length discrepancy, joint stiffness, and persistent pain. DISCUSSION: the proposed classification is simple, applicable, recallable and includes most scenarios of reconstructable TCBSTL. The classification provides a basis for communication, description and evaluation of such cases. The algorithm, based on our classification, provides a guideline for management without over/under treatment.
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Fijadores Externos , Fracturas Abiertas/cirugía , Técnica de Ilizarov , Traumatismos de los Tejidos Blandos/cirugía , Fracturas de la Tibia/cirugía , Adolescente , Adulto , Anciano , Algoritmos , Niño , Desbridamiento , Femenino , Fijación de Fractura/instrumentación , Fijación de Fractura/métodos , Curación de Fractura/fisiología , Fracturas Abiertas/complicaciones , Fracturas Abiertas/diagnóstico por imagen , Humanos , Ilion/trasplante , Puntaje de Gravedad del Traumatismo , Diferencia de Longitud de las Piernas/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/fisiopatología , Radiografía , Recuperación de la Función , Estudios Retrospectivos , Trasplante de Piel , Traumatismos de los Tejidos Blandos/complicaciones , Traumatismos de los Tejidos Blandos/diagnóstico , Fracturas de la Tibia/complicaciones , Fracturas de la Tibia/diagnóstico por imagen , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: A Morel-Lavallée lesion (MLL) is a rare and aesthetically concerning condition caused by a shearing force between subcutaneous fat and underlying fascia. Subsequent seroma formation occurs after the initial trauma of a crush injury, ligamentous sprain, or abdominal liposuction. Misdiagnosed lesions lead to inadequate treatment and are a source of chronic pain. CASE REPORT: The case of a 33-year-old woman who presented with a large, painful subacute MLL of the left thigh after being run over by a truck 3 weeks prior is reported. Physical examination revealed severe hyperesthesia and fluctuance of the left thigh. After confirmation of the fluid collection by X-ray and computed tomography angiogram, the authors performed liposuction of the cavity and seroma wall to evacuate and treat the lesion. Postoperative care consisted of a temporary drain, thigh compression, and oral antibiotics. Immediate reduction in size was appreciated intraoperatively with no reaccumulation of fluid at postoperative visits on week 1 and week 6. The pathology report confirmed seroma etiology, and all cultures of the fluid returned negative. At the end of her postoperative course, the patient reported a reduction in pain and no recurrence of her symptoms. CONCLUSIONS: This case of MLL was diagnosed early and successfully treated with liposuction, resulting in an acceptable cosmetic outcome. It is the authors' hope that this case report will lead to earlier diagnosis and proper treatment of MLLs.