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Medico-legal considerations for Morel-Lavallée lesions

  • Quentin ScanvionEmail author
  • Erwan Le Garff
  • Didier Gosset
  • Valéry Hédouin
  • Vadim Mesli
Case Report
  • 25 Downloads

Abstract

The Morel-Lavallée lesion is an infrequent traumatic lesion that the forensic physician may need to evaluate during examination of a victim. Using a review of the literature and an illustrative case, the objective of this paper is to discuss the medico-legal issues (accountability, functional recovery and healing times, and aftermath) associated with Morel-Lavallée lesions. We describe the case of a 24-year-old motorcycle driver who was hit by a car. Clinically, the right lumbar region had a large 16 × 15 cm ecchymosis with subcutaneous fluid swelling found by palpation. A body scan revealed a Morel-Lavallée lesion among other lesions. On day 7, its thickness was decreased by half. Morel-Lavallée lesions are specifically induced by shearing force with moderate-to-high kinetics in an anatomical area with an underlying fascia. The associated functional disability is globally moderate, but a large lesion or recurrences can extend the time needed to recover. Apart from some exceptions, care without any delay in diagnosis and treatment allows evolution of the lesion without functional consequences, but these lesions are frequently unnoticed in the initial phase.

Keywords

Morel-Lavallée Forensic medicine Subcutaneous tissue lesion Accidents 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Approval by Ethical Committee is not required for case reports as single case descriptions do not fulfil the criteria of research as defined by the Human Research Act. Patient information has been withheld to protect patient anonymity.

References

  1. 1.
    Nickerson TP, Zielinski MD, Jenkins DH, Schiller HJ. The Mayo Clinic experience with Morel-Lavallée lesions: establishment of a practice management guideline. J Trauma Acute Care Surg. 2014;76:493–7.CrossRefGoogle Scholar
  2. 2.
    Muneer M, El-Menyar A, Abdelrahman H, Murad MA, Al Harami SM, Mokhtar A, et al. Clinical presentation and management of pelvic Morel–Lavallee injury in obese patients. J Emerg Trauma Shock. 2019;12:40–7.Google Scholar
  3. 3.
    Bonilla-Yoon I, Masih S, Patel DB, White EA, Levine BD, Chow K, et al. The Morel-Lavallée lesion: pathophysiology, clinical presentation, imaging features, and treatment options. Emerg Radiol. 2014;21:35–43.CrossRefGoogle Scholar
  4. 4.
    Morel-Lavallée VAF. Épanchements traumatiques de sérosité. Arch Générales Médecine Paris. 1853.Google Scholar
  5. 5.
    Liu M, Liu L, Zhou X, Wu L, Wang J, Qi L, et al. A novel surgical technique for treatment of Morel-Lavallée lesion: endoscopic debridement combined with percutaneous cutaneo-fascial suture. Injury. 2018;49:1630–3.CrossRefGoogle Scholar
  6. 6.
    Moulin C, Barthélémy I, Emering C, D’Incan M. Syndrome de Morel-Lavallée et cytostéatonécrose : deux complications post-traumatiques simulant une dermo-hypodermite infectieuse. Ann Dermatol Vénéréologie. 2017;144:450–4.CrossRefGoogle Scholar
  7. 7.
    Scolaro JA, Chao T, Zamorano DP. The Morel-Lavallée lesion: diagnosis and management. J Am Acad Orthop Surg. 2016;24:667–72.CrossRefGoogle Scholar
  8. 8.
    Lungu E, Michaud J, Bureau NJ. US assessment of sports-related hip injuries. RadioGraphics. 2018;38:867–89.CrossRefGoogle Scholar
  9. 9.
    Khodaee M, Deu RS, Mathern S, Bravman JT. Morel-Lavallée lesion in sports. Curr Sports Med Rep. 2016;15:417–22.CrossRefGoogle Scholar
  10. 10.
    Mellado JM, Bencardino JT. Morel-Lavallée lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am. 2005;13:775–82.CrossRefGoogle Scholar
  11. 11.
    Tejwani SG, Cohen SB, Bradley JP. Management of Morel-Lavallee lesion of the knee: twenty-seven cases in the national football league. Am J Sports Med. 2007;35:1162–7.CrossRefGoogle Scholar
  12. 12.
    Dawre S, Lamba S, Harinatha S, Gupta S, Gupta AK. The Morel-Lavallee lesion: a review and a proposed algorithmic approach. Eur J Plast Surg. 2012;35:489–94.CrossRefGoogle Scholar
  13. 13.
    Greenhill D, Haydel C, Rehman S. Management of the Morel-Lavallée lesion. Orthop Clin North Am. 2016;47:115–25.CrossRefGoogle Scholar
  14. 14.
    Coulibaly NF, Sankale AA, Sy MH, Kinkpe CVA, Kasse AN, Diouf S, et al. Épanchement de Morel-Lavallée en chirurgie orthopédique (À propos de 19 cas). Ann Chir Plast Esthét. 2011;56:27–32.CrossRefGoogle Scholar
  15. 15.
    Anciaux P, Béjui J, Buu-Hoï P, Cantaloube D, Chikhani L, Chodkiewicz JP, et al. Barème indicatif d’évaluation des taux d’incapacité en droit commun. Le concours médical; 2001. http://www.expertisemedicale.be/upload/documents/documentation/Bareme_indicatif_d_evaluation.pdf. Accessed 24 June 2019.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.CHU Lille, Institut de Médecine Légale, EA 7367 UTML - Unité de Taphonomie Médico-LégaleUniversity of LilleLilleFrance

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