Progressive Hematoma in an Older Adult: Closed Internal Degloving Injury of the Knee

Closed internal degloving injury of soft-tissues has been reported in the pelvic-acetabular area after high-velocity trauma. More recently, this lesion has been reported in the knees of young athletes involved in contact sports. The injury is often brought late to the notice of the clinician, and sometimes the diagnosis is missed. Effective treatment relies heavily on clinical examination, and magnetic resonance imaging is helpful as a diagnostic tool. Treatment may depend on time between injury and presentation, patient age, collection severity, and the effects of previous treatment. Lesions that threaten skin vascularity and show rapid progression require emergency management. Minimally invasive techniques are preferred over extensive procedures. Elderly patients need to be observed for progression of the initial lesion and development of late complications, which may require emergency intervention. Clinicians should tailor the rehabilitation protocol to the patient’s age and the severity of the lesion.

This case report of a 55-year-old female patient covers the nature, diagnosis, and management of a progressively dissecting hematoma that evolved into a massive closed internal degloving lesion.