Endoscopic Treatment of a Morel-Lavallée Lesion – A Case Report
E.F. Temponi, Á.C. Castro, V.R. De Miranda, L.H. De Carvalho Junior, M.B.J. Goncalves, L.F.M. SoaresIntroduction:
Morel-Lavallée lesion (MLL) is a unique traumatic condition resulting from an abrupt shearing force between the subcutaneous tissue and the deep fascia, creating a potential space that fills with hemolymphatic fluid and necrotic debris. Clinical presentation varies with lesion extent but commonly includes swelling, fluctuance, and decreased skin sensitivity.
Case Report:
We present the case of a 37-year-old, previously healthy male who sustained direct thigh trauma following a motorcycle accident involving a truck run-over and crush injury. Magnetic resonance imaging confirmed an extensive MLL (>15 cm), prompting surgical intervention. The procedure involved arthroscopy with lateral portals, complete synovectomy, copious irrigation with saline solution, and direct debridement of clots and debris. This was followed by lateral fasciotomy and percutaneous fixation with prolene sutures to eliminate the dead space.
Discussion:
The combined technique of endoscopic debridement and percutaneous suture fixation proved effective in resolving the extensive MLL. Arthroscopic, rather than open, debridement confers less disruption of the soft tissues, improved hemostasis, and expedited recovery. This method may promote superior adhesion of tissue planes and a lower recurrence rate.