Morel-Lavallée lesions are closed degloving soft tissue injuries characterized by the separation of the skin and underlying tissue layers due to shearing forces. Candice MacMillan summarizes the pathophysiology, clinical presentation, diagnosis, and treatment of MLLs.
South Africa’s Sisanda Mangala falls to avoid a run out REUTERS/Siphiwe Sibeko.
In sports, Morel-Lavallée lesions (MLL) are associated with low-grade blunt force trauma related to falls and contact sports, such as football and wrestling. The injury is a post-traumatic closed degloving injury where skin and superficial fascia separate from the deep fascia, creating a potential space where blood and lymph accumulate(1-4). If not treated in the acute or early sub-acute stages, fluid accumulation is at risk for superinfection, overlying tissue necrosis, and continued expansion(1,3). Early, accurate diagnosis and treatment are vital.
The mechanism of injury is usually trauma that occurs tangential to fascial planes, resulting in a shearing type of injury(1-3). The superficial tissues (subcutaneous fat and dermis) are more mobile than the relatively firm and immobile deep fascia and muscle, subjecting these tissues to shearing injury(1-3). Shearing forces also lead to the perforation of vascular and lymphatic structures, resulting in the accumulation of hemolymphatic fluid in the potential space generated by the separation of the superficial and deep fascia (see figure 1)(1,3).
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