Shah Nawaz M Dodwad1, Steven R Niedermeier2, Elizabeth Yu1, Tania A Ferguson3, Eric O Klineberg4, Safdar N Khan5. 1. Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 W. 10th Ave., Columbus, OH 43201, USA. 2. College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH 43210, USA. 3. UW Orthopaedics and Sports Medicine, University of Washington, 1959 N.E. Pacific St., Box 356500, Seattle, WA 98195-6500, USA. 4. Department of Orthopaedics, University of California at Davis Medical Center, 3301 C St., Suite 1500, Sacramento, CA 95816, USA. 5. Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 W. 10th Ave., Columbus, OH 43201, USA. Electronic address: safdar.khan@osumc.edu.
Abstract
BACKGROUND CONTEXT: The Morel-Lavallée lesion occurs from a compression and shear force that usually separates the skin and subcutaneous tissue from the underlying muscular fascia. A dead space is created that becomes filled with blood, liquefied fat, and lymphatic fluid from the shearing of vasculature and lymphatics. If not treated appropriately, these lesions can become infected, cause tissue necrosis, or form chronic seromas. PURPOSE: To review appropriate identification and treatment of Morel-Lavallée lesions in spinopelvic dissociation patients. STUDY DESIGN: Uncontrolled case series. METHODS: Retrospective review of medical records. No funding was received in support of this study. The authors report no conflicts of interest. RESULTS: We present four cases of patients with traumatic spinopelvic dissociation. All had concomitant lumbosacral Morel-Lavallée lesions. All four trauma patients suffered traumatic spinopelvic dissociation with concomitant lumbosacral Morel-Lavallée lesions. Appropriate treatment included irrigation and debridement, drainage, antibiotics, and vacuum-assisted wound closure. CONCLUSIONS: Our series reflects an association of Morel-Lavallée lesion in spinopelvic dissociation trauma patients. Possibly, the rotatory injury that occurs at the spinopelvic junction creates a shear force to form the Morel-Lavallée lesion. When presented with a spinopelvic dissociation patient, one should be prepared to treat a Morel-Lavallée lesion.
BACKGROUND CONTEXT: The Morel-Lavallée lesion occurs from a compression and shear force that usually separates the skin and subcutaneous tissue from the underlying muscular fascia. A dead space is created that becomes filled with blood, liquefied fat, and lymphatic fluid from the shearing of vasculature and lymphatics. If not treated appropriately, these lesions can become infected, cause tissue necrosis, or form chronic seromas. PURPOSE: To review appropriate identification and treatment of Morel-Lavallée lesions in spinopelvic dissociationpatients. STUDY DESIGN: Uncontrolled case series. METHODS: Retrospective review of medical records. No funding was received in support of this study. The authors report no conflicts of interest. RESULTS: We present four cases of patients with traumatic spinopelvic dissociation. All had concomitant lumbosacral Morel-Lavallée lesions. All four traumapatients suffered traumatic spinopelvic dissociation with concomitant lumbosacral Morel-Lavallée lesions. Appropriate treatment included irrigation and debridement, drainage, antibiotics, and vacuum-assisted wound closure. CONCLUSIONS: Our series reflects an association of Morel-Lavallée lesion in spinopelvic dissociation traumapatients. Possibly, the rotatory injury that occurs at the spinopelvic junction creates a shear force to form the Morel-Lavallée lesion. When presented with a spinopelvic dissociationpatient, one should be prepared to treat a Morel-Lavallée lesion.