Khan Shujaa T, Pasqualini Ignacio, Pan Xuankang, Emara Ahmed M, Piuzzi Nicolas S
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
School of Medicine, Case Western Reserve University, Cleveland, Ohio.
J Orthop Case Rep. 2024 Jul;14(7):98-102. doi: 10.13107/jocr.2024.v14.i07.4590.
Morel-Lavallée lesion (MLL) is a closed degloving injury that occurs after traumatic damage to soft tissue, leading to the formation of an encapsulated serosanguinous collection of fluid. Although some MLLs resolve spontaneously, chronic MLLs present with a significant risk of infection and may impede patients' quality of life. Chronic lesions require surgical intervention to evacuate and debride the hematoma, often resulting in severe cosmetic damage postoperatively.
We documented a large 19.4 cm × 4.2 cm × 15.10 cm MLL on the right lateral hip that presented a significant impediment to the patient's daily functions. After the failure of conservative management, the patient was treated surgically through a minimal incision debridement procedure, utilizing a wound drain and vacuum-assisted compressional dressing upon closure. Excellent 1-year post-operative outcomes were achieved with no recurrence of the lesion and limited cosmetic evidence of the MLL.
This case highlights the value of a limited incisional debridement procedure for the management of a chronic Morel-Lavellée lesion. When using this technique, surgeons can effectively treat these lesions with promising short-term outcomes and minimal wound scarring.
莫雷尔-拉瓦利埃损伤(MLL)是一种闭合性脱套伤,发生于软组织受到创伤性损伤后,导致形成一个包裹性的含血清血液体聚集。尽管一些MLL可自行消退,但慢性MLL存在显著的感染风险,可能会影响患者的生活质量。慢性损伤需要手术干预以清除和清创血肿,术后常导致严重的美容损伤。
我们记录了一例位于右侧髋部外侧的巨大MLL,大小为19.4 cm×4.2 cm×15.10 cm,对患者的日常功能造成了严重阻碍。保守治疗失败后,患者通过小切口清创手术进行治疗,术中使用伤口引流管,并在缝合时采用真空辅助压迫敷料。术后1年取得了优异的效果,损伤未复发,MLL的美容痕迹有限。
本病例突出了有限切口清创手术在治疗慢性莫雷尔-拉瓦利埃损伤中的价值。使用该技术时,外科医生能够有效治疗这些损伤,获得良好的短期效果,并使伤口疤痕最小化。