LOWER EXTREMITY SANDBLAST INJURY: A RARELY SEEN INJURY MECHANISM IN THE CIVILIAN POPULATION

Objectives: Blast injuries are complex and multi-factorial in their pathophysiology. In the civilian population, blast injury is one of the mechanisms least familiar to most clinicians, yet it has the possibility of devastating injury. This is a case report of a 31-year-old male with no known previous medical problems who presented to a tertiary trauma center in South Central Appalachia after suffering a lower extremity injury while using an industrial sandblaster. In addition to the direct penetrating injury from sand particles, the proximity of the patient to the high-pressure sandblaster nozzle resulted in a blast injury. This blast injury presented as a closed degloving, or Morel-Lavallee lesion, which is uncommon and can easily be mistreated, leading to infection and further disability.

Following assessment, identification, and confirmation of the Morel-Lavallee lesion via radiographic imaging (Figure 1), this patient underwent debridement surgery, wound vac therapy, and antibiotic treatment before being discharged home with no major physiologic or neurologic deficits. This report highlights the importance of assessing for closed degloving injuries when presented with blast injury traumas in the civilian trauma setting, and outlines the process utilized for assessment and treatment.

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