A peculiar case of Morel-Lavelle lesion of upper limb
Morel-Lavallee lesions (MLL) are post-traumatic, closed internal degloving injuries that can result in severe complications if not diagnosed early. It is conventionally seen in cases of the high energy injuries of the pelvis and lower limb. The accumulation of extravasated blood, secondary to fractu...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Malaysian Medical Association
2020
|
| Online Access: | http://psasir.upm.edu.my/id/eprint/87631/ http://psasir.upm.edu.my/id/eprint/87631/1/ABSTRACT.pdf |
| _version_ | 1848860473304285184 |
|---|---|
| author | Ab Halim, Mohd Asyraf Hafizuddin Lekhraj Rampal, Sanjiv Rampal Devaraj, Navin Kumar Badr, Ismail Tawfeek |
| author_facet | Ab Halim, Mohd Asyraf Hafizuddin Lekhraj Rampal, Sanjiv Rampal Devaraj, Navin Kumar Badr, Ismail Tawfeek |
| author_sort | Ab Halim, Mohd Asyraf Hafizuddin |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Morel-Lavallee lesions (MLL) are post-traumatic, closed internal degloving injuries that can result in severe complications if not diagnosed early. It is conventionally seen in cases of the high energy injuries of the pelvis and lower limb. The accumulation of extravasated blood, secondary to fracture and soft tissue damage may cause internal degloving injury, skin necrosis, soft tissue damage and acute osteomyelitis. We report here the clinical and radiological features in a 32-year-old male referred from the emergency department of a tertiary hospital who had sustained high energy motor vehicle accident. On examination, there was a fluctuant, mobile, non-tender subcutaneous mass over the distal arm with suspicion of internal degloving injury. Plain radiographs showed no fractures. Ultrasound showed a fluid collection with the presence of septations and echogenic debris within the collection. Extravasation was noted between subcutaneous tissue layer and fascia at the posterolateral aspect of the arm. Wound debridement under general anaesthesia was carried out. Intraoperative findings reported a significant amount of thick serous fluid with necrotic debris. Unhealthy skin and fat layers were debrided. Underlying muscles were found to be healthy. The results of the intraoperative fluid culture and sensitivity showed no growth. Negative pressure vacuum dressing was carried out. After five cycles of vacuum dressing, the wound showed signs of healing with an improved range of motion of the elbow. Orthopaedic surgeons need to be vigilant of the possibility of MLL in the upper limb as a differential diagnosis in the management of high energy trauma. |
| first_indexed | 2025-11-15T12:45:47Z |
| format | Article |
| id | upm-87631 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T12:45:47Z |
| publishDate | 2020 |
| publisher | Malaysian Medical Association |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-876312022-07-06T04:49:02Z http://psasir.upm.edu.my/id/eprint/87631/ A peculiar case of Morel-Lavelle lesion of upper limb Ab Halim, Mohd Asyraf Hafizuddin Lekhraj Rampal, Sanjiv Rampal Devaraj, Navin Kumar Badr, Ismail Tawfeek Morel-Lavallee lesions (MLL) are post-traumatic, closed internal degloving injuries that can result in severe complications if not diagnosed early. It is conventionally seen in cases of the high energy injuries of the pelvis and lower limb. The accumulation of extravasated blood, secondary to fracture and soft tissue damage may cause internal degloving injury, skin necrosis, soft tissue damage and acute osteomyelitis. We report here the clinical and radiological features in a 32-year-old male referred from the emergency department of a tertiary hospital who had sustained high energy motor vehicle accident. On examination, there was a fluctuant, mobile, non-tender subcutaneous mass over the distal arm with suspicion of internal degloving injury. Plain radiographs showed no fractures. Ultrasound showed a fluid collection with the presence of septations and echogenic debris within the collection. Extravasation was noted between subcutaneous tissue layer and fascia at the posterolateral aspect of the arm. Wound debridement under general anaesthesia was carried out. Intraoperative findings reported a significant amount of thick serous fluid with necrotic debris. Unhealthy skin and fat layers were debrided. Underlying muscles were found to be healthy. The results of the intraoperative fluid culture and sensitivity showed no growth. Negative pressure vacuum dressing was carried out. After five cycles of vacuum dressing, the wound showed signs of healing with an improved range of motion of the elbow. Orthopaedic surgeons need to be vigilant of the possibility of MLL in the upper limb as a differential diagnosis in the management of high energy trauma. Malaysian Medical Association 2020 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/87631/1/ABSTRACT.pdf Ab Halim, Mohd Asyraf Hafizuddin and Lekhraj Rampal, Sanjiv Rampal and Devaraj, Navin Kumar and Badr, Ismail Tawfeek (2020) A peculiar case of Morel-Lavelle lesion of upper limb. Medical Journal of Malaysia, 75 (5). 594 - 596. ISSN 0300-5283 http://www.e-mjm.org/2020/v75n5/index.html |
| spellingShingle | Ab Halim, Mohd Asyraf Hafizuddin Lekhraj Rampal, Sanjiv Rampal Devaraj, Navin Kumar Badr, Ismail Tawfeek A peculiar case of Morel-Lavelle lesion of upper limb |
| title | A peculiar case of Morel-Lavelle lesion of upper limb |
| title_full | A peculiar case of Morel-Lavelle lesion of upper limb |
| title_fullStr | A peculiar case of Morel-Lavelle lesion of upper limb |
| title_full_unstemmed | A peculiar case of Morel-Lavelle lesion of upper limb |
| title_short | A peculiar case of Morel-Lavelle lesion of upper limb |
| title_sort | peculiar case of morel-lavelle lesion of upper limb |
| url | http://psasir.upm.edu.my/id/eprint/87631/ http://psasir.upm.edu.my/id/eprint/87631/ http://psasir.upm.edu.my/id/eprint/87631/1/ABSTRACT.pdf |