Degloving injuries can refer to a number of conditions. Ultrasound and mri characteristics of such lesions have been previously described and can be helpful in establishing a diagnosis and guiding clinical management. Pdf the morel lavallee lesion is a closed softtissue degloving injury commonly associated with highenergy trauma. The thigh, hip, and pelvic region are the most commonly affected locations. May 16, 2015 the treatment for your morel lavallee lesion depends a bit on how long ago your injury was and the current nature of the lesion. Morel lavallee lesions, strictly speaking, occur in the thigh. Article information, pdf download for oxytetracycline as a sclerosant in. There are tiny echoes, few thin septa, and fat globules within the lesion. Some authors have suggested that the predilection of mll to occur in certain regions was likely related to a variation of the anatomical structure of the adipose tissue. Longstanding morellavallee lesions of the trochanteric region and proximal thigh may present various mri patterns that reflect their variable composition and stage of development. There is anechoic lesion in subcutaneous plane of proximal thigh on lateral aspect. Oxytetracycline as a sclerosant in the management of morel. Previous treatments included repeated aspiration and excision of the bursa with elastic compression bandaging.
Morellavallee described a closed degloving injury in. Many cases of mll are missed at the initial evaluation, and the treatment of mll is not well established. Morel lavallee syndrome or lesion was first described by a french surgeon, victor morel lavallee, in 1863. The clinical manifestation of mll varies from soft fluctuant swelling to skin necrosis or wound sepsis. We present two cases in which mll was missed at the initial evaluation. The lesions classically occur over the greater trochanter of the femur 1. The illustration above indicates the most common locations for morellavallee lesions to occur, from dark red being the most common, to light pink being the least common. The morellavallee lesion is a rare condition that was first described by the french physician maurice morellavallee in 1853. Morellavallee lesion mll mimicking a soft tissue neoplasm article pdf available in journal of clinical and diagnostic research 94. Morel lavallee lesion on the lateral thighaspiration. Morel lavallee lesions in orthopedics healios wound.
Due to its inconsistent clinical manifestations and. Morellavallee lesion in the upper extremity grant k. Morellavallee lesions are a form of closed degloving injury that leads to fluid accumulation and the formation of a pseudocyst. However, similar biomechanical forces to the lumbar region, over the scapula, or over the knee can result in identical lesions and these are often also called morel lavallee lesions 1,3 pathology. The injury was sustained after striking his right knee against a post whilst horse riding 9 months ago. Pdf morellavallee lesion mll mimicking a soft tissue.
Pdf the morellavallee lesion is a closed softtissue degloving injury commonly associated with. Percutaneous drainage of morellavallee lesions when the diagnosis is delayed m orellavallee lesions are a closed internal degloving that occurs most commonly over the greater trochanter region, but can also occur in other regions, such as the knee. The cavity developed and filled with fluid such as hematoma or liquefied fat etc. We present a case of a morellavallee lesion of the elbow, with ultrasound and mri correlation, which has not been reported in the radiology literature heretofore. I cannot find much on the net it seems to be somewhat rare. Diagnosis is through a combination of clinical examination, history, and imaging studies. Treatment of rare morellavallee lesion of arm with liposuction. Endoscopic treatment of morellavallee lesion sciencedirect. Morel lavallee lesion mll is an uncommon condition consisting of a closed degloving injury caused by forces that create pressure and shear. Morel lavallee lesion results of surgical drainage with the use of synthetic glue murat demirel, md, ferit dereboy, md, ali ozturk, md, egemen turhan, md, tarik yazar, md. The morellavallee lesion has been originally described by the french surgeon victor auguste francois morellavallee in 1863. Longstanding morellavallee lesions of the trochanteric.
Differential diagnosis includes ganglion cyst, fat necrosis, sarcoma, hemangioma, subcutaneous hematoma, aneurysmal bone cyst. Jun 17, 2016 morel lavallee lesions in orthopedics a morel lavallee lesion is a posttraumatic soft tissue degloving injury, originally described by french surgeon victor auguste francois morel lavallee in 1863. Morellavallee lesion initially diagnosed as quadriceps. Morel lavallee lesions in orthopedics healios wound solutions. These lesions result from direct or tangential shearing forces that separate the skin and subcutaneous tissues from the underlying fascia. The morellavallee lesion is a closed degloving injury. A morellavallee lesion represents a closed degloving injury associated with severe trauma which then presents as a hemolymphatic mass. Early diagnosis and management is essential to avoid complications such as infection or extensive skin necrosis. Department of diagnostic and interventional radiology, tan tock seng hospital, jalan tan tock, singapore abstract. Part of the lesion overlies greater trochanter of femur.
Morellavallee lesions mlls, also known as degloving injuries, were first described. T 1weighted coronal image of the patients left thigh showing encapsulated longstanding morellavallee lesion in close relationship with muscle bellies of the tensor fascia lata and gluteus maximus muscles. Morellavallee lesion of the elbow with ultrasound and mri. I have developed a morel lesion following a bad bike crash 6 mo ago. Percutaneous drainage of morellavallee lesions when the. Pdf morellavallee lesion is a degloving injury occurring at the interface of the subcutaneous fat and the underlying. Td01td02 april 2015 with 31 reads how we measure reads. The morellavallee lesion is a rare but important cause of calf swelling.
A morellavallee lesion is a relative ly rare condition involving a closed, degloving injury to the pelvis, result. The morel lavallee lesion is a closed softtissue degloving injury commonly associated with highenergy trauma. Between january 2006 and december 20, we performed delayed surgical debridement on morellavallee lesions, after delimitation of the local tissue necrosis, followed by closure through second intention andor use of graftsflaps. Management of morellavallee lesion associated with pelvic. Pdf the morellavallee lesion is a closed softtissue degloving injury commonly associated with highenergy trauma. A morel lavallee lesion is a posttraumatic soft tissue degloving injury, originally described by french surgeon victor auguste francois morel lavallee in 1863. Pdf morel lavallee lesion is a degloving injury occurring at the interface of the subcutaneous fat and the underlying fascia. Morellavallee lesions are haemolymphatic collections that occur. Apr 09, 2015 first, the lesion was extremely large for its location. At one month, if there is a persistent fluid collection, then this may have become encapsulated. Article information, pdf download for morellavallee lesion in the upper. It was first described in 1848 by french physician victor auguste francosis morel lavallee. The morel lavallee lesion is a posttraumatic collection of fluid arising after a closed degloving injury has caused the separation of the skin and subcutis from the underlying muscular fascia. To our knowledge our patients lesion may in fact be the largest documented in this region, measuring at 26cm craniocaudal, 6.
Though they are not uncommon, they are rarely diagnosed which results in delay in their treatment. Morel lavallee syndrome is closed internal degloving of subcutaneous tissue from the underlying fascia by trauma. Mri is the imaging modality of choice for evaluation. Apr 29, 2012 morel lavallee lesions mll are rarely diagnosed posttraumatic sequel. There are very few published accounts of massive mlls occurring in the medial thighknee. The opinions and assertions contained herein are those of the authors and should not be construed as official or as representing the opinions of the department of the air force, the department of the army, or the department of defense. Originally described at the external aspect of the thigh. The chain of events leading to the occurrence of this lesion is the formation of a potential space between the subcutaneous tissue and the firmly attached deep fascia, which. Liposuction cannulas can easily drain fluid collections and could be helpful in removing necrotic tissue. Longstanding morellavallee lesion of the thigh simulating a.
In this condition, hemolymph is collected in the closed space between the separated subcutaneous tissue and the underlying fascia. A morellavallee lesion on the left leg of a 14yearold boy who had a blunt trauma to his leg is shown. The scan of the leg showed a large subcutaneous fluid collection overlying the muscular fascia with free floating adipose tissue within the fluid. A morel lavallee lesion mll involves posttraumatic fluid collection around the greater trochanter. Morel lavallee lesion is a common but rarely described posttraumatic closed soft tissue injury sequel.
Morel lavallee lesions in orthopedics a morel lavallee lesion is a posttraumatic soft tissue degloving injury, originally described by french surgeon victor auguste francois morel lavallee in 1863. Timely identification and management of a morellavallee lesion is crucial because distracting injuries in the polytraumatized patient can result in a missed or delayed diagnosis. Can liposuction be used to treat a morellavellee lesion. The most frequent mechanism of occurrence is posttraumatic, usually after degloving injuries. Morellavallee lesions are haemolymphatic collections that occur following blunt trauma. Timely identification and management of a morel lavallee lesion is crucial because distracting injuries in the polytraumatized patient can result in a missed or delayed diagnosis. The mechanism of trauma consists of a degloving injury causing sudden shearing forces at the interface of the superficial fascia and subcutaneous fat. A morellavallee lesion is a closed degloving injury in which the skin and. They follow closed degloving injuries due to accumulation of blood and debris in the subcutaneous plane. The image also shows a mildly heterogeneous mass and hyperintensity relative to the.
Mri may prove especially useful for characterizing these lesions when the trauma is remote and progressive growth or pain is present. Has anyone ever had the surgery of debriding this type of lesion. Results from surgical treatment of morellavallee lesions. Dec 30, 20 morel lavallee lesion mll is a closed degloving injury resulting from blunt shearing or tangential forces. A 72 yearoldmale was referred to our institution with recalcitrant prepatellar bursitis. Morellavallee lesion is a rarely occurring sequela after blunt injury, most commonly occurring in the area of the hip and lower extremities. The patient was followed clinically as an outpatient, and at 6month followup he was doing well and had no evidence of recurrence of the lesion.
94 326 608 836 470 438 528 554 493 1262 959 569 814 423 1438 522 131 1066 454 811 1083 845 143 713 891 455 1303 1472 692 301 475 1396