Abstract
BACKGROUND
: Morel-Lavallée lesions, also known as an internal degloving injuries, occur hours
to months after high-speed sheering trauma, usually in the peri-trochanteric region.
These are uncommon injuries, and are often missed as part of the trauma exam. 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 ago. 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 quickly and cost-effectively
diagnosed in the ED through the combination of a thorough history, physical exam,
and bedside ultrasound. While 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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Article Info
Publication History
Accepted:
October 21,
2022
Received in revised form:
August 16,
2022
Received:
June 29,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
