The Morel-Lavallée Lesion: Diagnosis and Management

Abstract

The Morel-Lavallée lesion is a closed soft-tissue degloving injury commonly associated with high-energy trauma. The thigh, hip, and pelvic region are the most commonly affected locations. Timely identification and management of a Morel-Lavallée lesion is crucial because distracting injuries in the polytraumatized patient can result in a missed or delayed diagnosis. Bacterial colonization of these closed soft-tissue injuries has resulted in their association with high rates of perioperative infection. Recently, MRI has been used to characterize and classify these lesions. Definitive management is dictated by the size, location, and age of the injury and ranges from percutaneous drainage to open débridement and irrigation. Chronic lesions may lead to the development of pseudocysts and contour deformities of the extremity.

Clinical presentation and management of pelvic Morel–Lavallee injury in obese patients

“…reported that the definitive MLL treatment is guided by the size, location, and age of the lesion. [ 35 ] However, there is no universally accepted treatment algorithm for MLL and still the diagnosis and management based on the treating surgeon knowledge, imaging characteristics, and treatment availability. [ 25 ]…”

Utilization of Liposuction for Delayed Morel-Lavallée Lesion: A Case Report and Review

“…In addition, the space allows the accumulation of blood, necrotic fat, lymphatic fluid, and other inflammatory mediators. These types of lesions/accumulations have been described following high-energy trauma, such as motor vehicle incidents, assaults, sport-related injuries [ 1 , 2 ], and surgical procedures, such as abdominoplasty, with [ 3 , 4 ] and without [ 5 ] liposuction.…”

“…Other case series have similarly demonstrated higher predilection for lower extremity involvement with 60% [ 9 ] up to 81% [ 10 ]. If MLL remains untreated, a prolonged inflammatory process may ensue instigating formation of a pseudocyst leaving potential for infection and necrosis [ 1 ].…”

“…Multiple medical settings use plain film X-ray radiography and have found it useful. Plain film X-ray radiography may be beneficial in the immediate posttraumatic setting to evaluate for adjacent fractures, such as femur or pelvis, but however, remains nonspecific for MLL [ 1 ]. In the setting of MLL, plain films may demonstrate mass effect of soft tissue without calcification or fat layer infiltration [ 11 ].…”

“…Shearing trauma may subsequently lead to the creation of a pocket between soft-tissue layers, leading to encapsulation and/or contour deformity. Providers often refer to MLL as a posttraumatic pseudocyst or closed soft-tissue degloving injury [ 1 , 2 ].…”