Morel-Lavallée lesion after falling down stairs, diagnosed with ultrasound: A case report

Abstract

The Morel-Lavallée lesion is an uncommon closed degloving injury that most often occurs in the setting of high-energy trauma and can be associated with other traumatic injuries, including fractures of the pelvis, acetabulum, or femur. The superficial soft tissues are forcibly separated from the underlying deep fascia, resulting in damage to penetrating blood vessels and lymphatics. A fluid collection consisting of lymph, blood, and/or necrotic tissue subsequently develops and is most common in the region of the greater trochanter. Awareness of this entity is important to prevent a delay in diagnosis and decrease the risk of potential complications such as pseudocyst formation, pressure necrosis of the overlying skin, chronic pain, and infection. We present the case of a 49-year-old man who noticed a fluid collection in his right lateral upper thigh 1 week after slipping and falling down half a flight of stairs. Ultrasound demonstrated a fusiform fluid collection between the subcutaneous fat and underlying deep fascia, consistent with a Morel-Lavallée lesion. After reviewing various treatment options, the patient elected to undergo nonsurgical management. The lesion persisted but substantially improved 6 weeks after the initial injury. This case underscores the need to consider Morel-Lavallée lesions in the appropriate clinical context.

Keywords

• Morel-Lavallée lesion
• Closed degloving injury
• Fluid collection
• Ultrasound