[The Morel-Lavallée lesion: a conservative approach to closed degloving injuries]

Abstract

Objectives: We evaluated the results of conservative treatment for closed degloving injuries (Morel-Lavallée lesion) of the pelvic girdle and lower extremities.

Methods: The Morel-Lavallée lesion developed in five male patients (mean age 25.6 years; range 6 to 40 years) due to crush under a vehicle (n=3) and traffic accidents (n=2). The lesions were localized in the pelvic girdle in three cases (2 lumbosacral, 1 lateral lumbar) and gluteal and trochanteric regions in two cases. Treatment was performed with compressive elastic bandages or corsets in all the patients, three of whom also underwent surgery due to accompanying pelvic fractures. Healing was defined as the loss of fluctuation and elicitation of the normal mobility of the injured skin on manual examination. The mean follow-up period was 23.6 months (range 10 to 41 months).

Results: Sacral decubitus ulcer developed in a patient in whom the detection of the lesion was obscured because of an associated femoral fracture and a perianal deep soft tissue lesion. Another patient with a wide fluctuating lesion in the gluteal-trochanteric region required aspiration, which yielded a negative culture. However, the lesion recurred early. Except for the patient with a sacral decubitus ulcer, all the lesions healed within a mean of six weeks (range 4 to 12 weeks) without any infections or necrosis. No recurrences were detected during the follow-up period.

Conclusion: Closed degloving lesions in the pelvic and gluteal regions can be managed conservatively when the overlying skin is intact and the fluid accumulation is not excessive.