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Morel-Lavallee lesions. Size matters? Treatment and time of disability
Juan Miguel Rodríguez-Roiz1, Jordi Montañana Burillo2, José Simón Sanchez Díaz2
1Orthopaedic & Trauma Surgery Department, Mutua Universal Delfos Clinic, Vallcarca Av 151, Barcelona, Spain; Quiron Aribau Barcelona, Orthopaedics Department, Aribau 192,198, Barcelona, Spain.
Introduction:
Degloving soft-tissue injuries are serious and potentially devastating medical conditions where an early recognition is a crucial step for a favorable outcome. One of the most important types is Morel-Lavallée lesions (MLL); a significant soft-tissue injury associated with pelvic trauma (30%) and thigh (20%), located over the greater trochanter.
Material And Methods:
In this retrospective study we selected adult patients diagnosed with MLL between 2010 and 2019 at our trauma center. We then identified 9 cases and followed them up for a minimum of two years. CT scans were performed to measure the size of the degloved zone.
Results:
we did not found direct relationship between greater dimensions of MLL injury and the need for an increase of days to return to work. We rather identified an association between bigger dimensions of MLL injury and higher energy trauma. These patients waited an average of 133 days to return to work after being injured; which is a longer period compared to non-op patients.
Discussion:
MLL lesions generally take several days to develop and many may be missed on initial evaluation. Once identified, compression dressings should be applied, especially when diagnosed acutely. Early identification would lead to early operative debridement. Also, drainage should be performed, since the pathophysiology of the injury will result in the failure of observation or simple aspiration.
Conclusion:
MLL diagnosis and treatment must be identified as early as possible. We didn't find a correlation between MLL size and the treatment performed. In our study all patients returned to their jobs and normal life. Patients following conservative treatment take longer time to recover and could require more patient's implication, but -at least- would avoid possible surgical complications.
