Abstract
Background
Morel-Lavallée lesions, also known as an internal degloving injuries, occur hours
to months after high-speed shearing trauma, usually in the peri-trochanteric region.
These are uncommon injuries, and are often missed as part of the trauma examination.
Failure to diagnose or treat these lesions may result in complications, such as infected
seromas, chronic cosmetic deformities, capsule formation, or skin necrosis. There
are no formalized societal guidelines for management, but smaller studies have recommended
compression alone for asymptomatic lesions, aspiration for small symptomatic lesions,
and open debridement for large lesions.
Case Report
A young woman presented with swelling, fluctuance, and paresthesia to her right hip
after falling off her bicycle 1 week earlier. Physical examination showed a fluctuant
and hypoesthetic area over the greater trochanter and point-of-care ultrasound showed
a hypoechoic and compressible fluid collection between a fascial layer and a subcutaneous
layer, confirming the diagnosis of a Morel-Lavallée lesion (internal degloving injury).
Symptoms did not improve with compression alone, but did improve after fluid aspiration.
Why Should an Emergency Physician Be Aware of This?
Morel-Lavallée lesions are frequently missed traumatic injuries. Morel-Lavallée lesions
can be diagnosed quickly and cost-effectively in the emergency department through
the combination of a thorough history, physical examination, and bedside ultrasound.
Although there are no formal societal guidelines, limited studies suggest management
strategies, including compression, aspiration, and open debridement, with treatments
varying by symptom severity and lesion size.
Keywords
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References
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Article info
Publication history
Published online: November 01, 2022
Accepted:
October 21,
2022
Received in revised form:
August 16,
2022
Received:
June 29,
2022
Publication stage
In Press Corrected ProofFootnotes
Streaming video: One brief real-time video clip that accompanies this article is available in streaming video at https://www.jem-journal.com/article/S0736-4679(22)00647-3/fulltext#supplementaryMaterial. Click on Video Clip 1.
RECEIVED: 29 June 2022; FINAL SUBMISSION RECEIVED: 16 August 2022; ACCEPTED: 21 October 2022
Identification
Copyright
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