Morel-Lavallee lesions. Size matters? Treatment and time of disability

Published:October 22, 2022DOI:



      Degloving soft-tissue injuries are serious and potentially devastating medical conditions where an early recognition is a crucial step for a favorable outcome. One of the most important types is Morel-Lavallée lesions (MLL); a significant soft-tissue injury associated with pelvic trauma (30%) and thigh (20%), located over the greater trochanter.

      Material and methods

      In this retrospective study we selected adult patients diagnosed with MLL between 2010 and 2019 at our trauma center. We then identified 9 cases and followed them up for a minimum of two years. CT scans were performed to measure the size of the degloved zone.


      we did not found direct relationship between greater dimensions of MLL injury and the need for an increase of days to return to work. We rather identified an association between bigger dimensions of MLL injury and higher energy trauma. These patients waited an average of 133 days to return to work after being injured; which is a longer period compared to non-op patients.


      MLL lesions generally take several days to develop and many may be missed on initial evaluation. Once identified, compression dressings should be applied, especially when diagnosed acutely. Early identification would lead to early operative debridement. Also, drainage should be performed, since the pathophysiology of the injury will result in the failure of observation or simple aspiration.


      MLL diagnosis and treatment must be identified as early as possible. We didn't find a correlation between MLL size and the treatment performed. In our study all patients returned to their jobs and normal life. Patients following conservative treatment take longer time to recover and could require more patient's implication, but -at least- would avoid possible surgical complications.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Morel-Lavallée M.
        Epanchements traumatique de serosite.
        Arc Générales Méd. 1853; : 691-731
        • Morel-Lavallee V.A.F.
        Decollements traumatiques de la peau et des couches sous-jacentes.
        Arch Gen Med. 1863; 1: 300-332
        • Archier E.
        • Grillo J.C.
        • Fourcade S.
        • Gaudy C.
        • Grob J.J.
        • Richard M.A.
        Morel- Lavallée syndrome of the lower leg.
        Ann Dermatol Venereol. 2012; 139: 216-220
        • Hudson D.A.
        Missed closed degloving injuries: late presentation as a contour deformity.
        Plast Reconstr Surg. 1996; 98: 334-337
        • Tseng S.
        • Tornetta P.
        3rd Percutaneous management of Morel-Lavallée lesions.
        J Bone Joint Surg Am. 2006; 88: 92-96
        • Tsur A.
        • Galin A.
        • Kogan L.
        • Loberant N.
        Morel-Lavallée syndrome after crush injury.
        Harefuah. 2006; 145: 111-113
        • Hak D.J.
        • Olson S.A.
        • Matta J.M.
        Diagnosis and management of closed internal degloving injuries associated with pelvic and acetabular fractures: the Morel-Lavallée lesion.
        J Trauma. 1997; 42: 1046-1051
        • Tejwani S.G.
        • Cohen S.B.
        • Bradley J.P.
        Management of Morel-Lavallée lesion of the knee: twenty-seven cases in the national football league.
        Am J Sports Med. 2007; 35: 1162-1167
        • Powers M.L.
        • Halem S.F.
        • Sundaram M.
        Diagnosis: morel-Lavalee lesion.
        Orthopedics. 2007; 30: 322-323
        • Gebe J.M.
        • Sila C.A.
        • Ganger C.B.
        • Weisenberg J.P.
        • Geen C.L.
        • Topol E.J.
        • Mahaffey K.W.
        Comparison of the ABC /2 estimation technique to computer-assisted volumetric analisis of intraparenquymal and subdural hematomas complicating the GUSTO-1 trial.
        Stroke. 1998; 29: 1799-1801
        • Harma A.
        • Inan M.
        • Ertem K.
        The Morel-Lavallée lesion: a conservative approach to closed degloving injuries.
        Acta Orthop Traumatol Turc. 2004; 38: 270-273
        • Kottmeier S.A.
        • Wilson S.C.
        • Born C.T.
        • Hanks G.A.
        • Iannacone W.M.
        • DeLong W.G.
        Surgical management of soft tissue lesions associated with pelvic ring injury.
        Clin Orthop Relat Res. 1996; 329: 46-53
        • Routt Jr, M.L.
        • Simonian P.T.
        • Ballmer F.
        A rational approach to pelvic trauma. Resuscitation and early definitive stabilization.
        Clin Orthop Relat Res. 1995; 318: 61-74
        • Helfet D.L.
        • Schmeling G.J.
        • Tile M.
        Fractures of the pelvis and acetabulum.
        2nd ed. Williams and Wilkins, Baltimore1995: 451-467
        • Boyle K.A.
        • Carver T.W.
        Morel-Lavallée Lesions.
        Curr Trauma Rep. 2018; 4: 289-298
        • Mikic Z.D.
        Operative treatment of the large post-traumatic subcutaneous haematoma or bursa.
        Injury. 1992; 23: 327-330
        • MIR y MIR L.
        • Morgadas Novell A
        Repair of necrotic cutaneous lesions, secondary to tangential traumatism over detachable zones.
        Plast Reconstr Surg;. 1946; 6: 264-274
        • Shen C.
        • Peng J.P.
        • Chen X.D.
        Efficacy of treatment in peri-pelvic Morel- Lavallee lesion: a systematic review of the literature.
        Arch Orthop Trauma Surg. 2013; 133: 635-640
        • Tejwani S.G.
        • Cohen S.B.
        • Bradley J.P.
        Management of Morel Lavallee lesion of the knee: twenty-seven cases in the national football league.
        Am J Sports Med. 2007; 35: 1162-1167
        • Hudson D.A.
        • Knottenbelt J.D.
        • Krige J.E.
        Closed degloving injuries: results following conservative surgery.
        Plast Reconstr Surg. 1992; 89: 853-855
        • Nickerson T.P.
        • Zielinski M.D.
        • Jenkins D.H.
        • Schiller H.J.
        The Mayo Clinic experience with Morel-Lavallee lesions: establishment of a practice management guideline.
        J Trauma Acute Care Surg. 2014; 76: 493-497
        • Shen C.
        • Peng J.P.
        • Chen X.D.
        Efficacy of treatment in peri-pelvic Morel- Lavallee lesion: a systematic review of the literature.
        Arch Orthop Trauma Surg. 2013; 133: 635-640
        • Isaacson A.J.
        • Stavas J.M.
        Image-guided drainage and sclerodesis of a Morel-Lavallee lesion.
        J Vasc Interv Radiol. 2013; 24: 605-606
        • Diviti S.
        • Gupta N.
        • Hooda K.
        • Sharma K.
        • Lo L.
        Morel-Lavallee lesions-review of pathophysiology, clinical findings, imaging findings and management.
        J Clin Diagn Res. 2017; 11: TE01-TE04
        • Mooney M.
        • Gillette M.
        • Kostiuk D.
        • Hanna M.
        • Ebraheim N.
        Surgical treatment of a chronic Morel-Lavallée lesion: a case report.
        J Orthop Case Rep. 2019; 9: 15-18
        • Choudhary A.K.
        • Methratta S.
        Morel-Lavallee lesion of the thigh: characteristic findings on US.
        Pediatr Radiol. 2010; 40: S49
        • Bansal A.
        • Bhatia N.
        • Singh A.
        • Singh A.K.
        Doxycycline sclerodesis as a treatment option for persistent Morel-Lavallee lesions.
        Injury. 2013; 44: 66-69
        • Gardner P.
        • Flis D.
        • Chaiyasate K.
        Utilization of liposuction for delayed Morel-Lavallee lesion: a case report and review.
        Case Rep Surg. 2017; 20178120587