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The Swelling That Would Not Settle: A Four-Month Journey to Diagnosing a Morel-Lavallée Lesion
Imran F Gul1, Mohd Shahril Jaapar2, Syahril Izwan Alias3
1Orthopaedics, Universiti Putra Malaysia, Serdang, MYS.
Abstract:
Morel-Lavallée lesions (MLL) are closed degloving injuries caused by shearing forces that separate the skin and tissue from the deep fascia. This creates a space where blood and lymphatic fluid can collect if not found early. MLL often happen after high-energy trauma and may be missed when other injuries seem more urgent. A 35-year-old motorcyclist developed a swelling on his left thigh after an accident. At first, it was thought to be just a bruise. Over the next few months, the swelling grew and became more painful. Ultrasound and CT scans showed a large, multiloculated fluid collection, which matched a chronic MLL. Surgery drained about one liter of fluid through two incisions. After the wound was closed, the patient recovered fully without complications. This case shows that MLL can be missed, especially when the first injury seems minor. If the condition becomes chronic, surgery is often needed because a fibrous capsule forms around the fluid. If swelling lasts after an injury, clinicians should consider MLL. Early imaging and quick treatment can lower the risk of complications and help patients recover better.
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