Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 5/2013

01.05.2013 | Trauma Surgery

Efficacy of treatment in peri-pelvic Morel–Lavallee lesion: a systematic review of the literature

verfasst von: Chao Shen, Jian-Ping Peng, Xiao-Dong Chen

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Morel-Lavallee lesion (MLL) of the peri-pelvic region is less common and various treatments have been introduced to manage the lesion. No standard treatment is recommended. We performed a systematic review of literature to (1) identify the classification of peri-pelvic MLL; (2) review the treatments of the lesion and their complications; (3) define the optimal treatment of peri-pelvic MLL.

Methods

A systematic search was performed via PubMed, ISI Web of Knowledge, and Embase for English abstract articles from 1966 to 2012. We identified 21 articles detailing 153 patients with peri-pelvic MLL, most of which were level IV studies. The treatments and clinical results were reviewed.

Results

For peri-pelvic MLL patients, surgical intervention was better than conservative therapy. Sclerhodesis method is attended with good outcome in the symptomatic MLL patients without fractures. Patients with peri-pelvic fractures could be managed with local suction drainage or open debridement with dead space closure technique during fracture fixation. The delayed-diagnosis cases might be treated with mass resection when fibrosis capsule was obtained in magnetic resonance imaging.

Conclusions

Peri-pelvic MLL can be treated with various surgical methods depending on the formation of fibrosis capsule and associated injuries. Dead space closure technique is emphasized in the treatment of MLL. Higher quality of literature is required to prove this result in future research.
Literatur
1.
Zurück zum Zitat Morel-Lavallee (1863) Decollements traumatiques de la peau et des couches sous-jacentes. Arch Gen Med (1):20-38, 172-200, 300–332 Morel-Lavallee (1863) Decollements traumatiques de la peau et des couches sous-jacentes. Arch Gen Med (1):20-38, 172-200, 300–332
2.
Zurück zum Zitat Vico PG (2000) Morel-Lavallee syndrome. Eur J Plast Surg 23(1):45–48CrossRef Vico PG (2000) Morel-Lavallee syndrome. Eur J Plast Surg 23(1):45–48CrossRef
3.
Zurück zum Zitat Parra JA, Fernandez MA, Encinas B, Rico M (1997) Morel-Lavallee effusions in the thigh. Skelet Radiol 26(4):239–241CrossRef Parra JA, Fernandez MA, Encinas B, Rico M (1997) Morel-Lavallee effusions in the thigh. Skelet Radiol 26(4):239–241CrossRef
4.
Zurück zum Zitat Mellado JM, Bencardino JT (2005) Morel-Lavallee lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am 13(4):775–782PubMedCrossRef Mellado JM, Bencardino JT (2005) Morel-Lavallee lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am 13(4):775–782PubMedCrossRef
5.
Zurück zum Zitat Kalaci A, Karazincir S, Yanat AN (2007) Long-standing Morel-Lavallee lesion of the thigh simulating a neoplasm. Clin Imaging 31(4):287–291PubMedCrossRef Kalaci A, Karazincir S, Yanat AN (2007) Long-standing Morel-Lavallee lesion of the thigh simulating a neoplasm. Clin Imaging 31(4):287–291PubMedCrossRef
6.
Zurück zum Zitat Puig J, Pelaez I, Banos J, Balliu E, Casas M, Maroto A, Pedraza S (2006) Long-standing Morel-Lavallee lesion in the proximal thigh: ultrasound and MR findings with surgical and histopathological correlation. Australas Radiol 50(6):594–597PubMedCrossRef Puig J, Pelaez I, Banos J, Balliu E, Casas M, Maroto A, Pedraza S (2006) Long-standing Morel-Lavallee lesion in the proximal thigh: ultrasound and MR findings with surgical and histopathological correlation. Australas Radiol 50(6):594–597PubMedCrossRef
7.
Zurück zum Zitat Mellado JM, Perez del Palomar L, Diaz L, Ramos A, Sauri A (2004) Long-standing Morel-Lavallee lesions of the trochanteric region and proximal thigh: MRI features in five patients. AJR Am J Roentgenol 182(5):1289–1294PubMedCrossRef Mellado JM, Perez del Palomar L, Diaz L, Ramos A, Sauri A (2004) Long-standing Morel-Lavallee lesions of the trochanteric region and proximal thigh: MRI features in five patients. AJR Am J Roentgenol 182(5):1289–1294PubMedCrossRef
8.
Zurück zum Zitat Penaud A, Quignon R, Danin A, Bahe L, Zakine G (2011) Alcohol sclerodhesis: an innovative treatment for chronic Morel-Lavallee lesions. J plast, Reconstr Aesthet surg : JPRAS 64(10):e262–264CrossRef Penaud A, Quignon R, Danin A, Bahe L, Zakine G (2011) Alcohol sclerodhesis: an innovative treatment for chronic Morel-Lavallee lesions. J plast, Reconstr Aesthet surg : JPRAS 64(10):e262–264CrossRef
9.
Zurück zum Zitat Bansal A, Bhatia N, Singh A, Singh AK (2013) Doxycycline sclerodesis as a treatment option for persistent Morel-Lavallee lesions. Injury 44(1):66–69 Bansal A, Bhatia N, Singh A, Singh AK (2013) Doxycycline sclerodesis as a treatment option for persistent Morel-Lavallee lesions. Injury 44(1):66–69
10.
Zurück zum Zitat Steiner CL, Trentz O, Labler L (2008) Management of Morel-Lavallee lesion associated with pelvic and/or acetabular fractures. Eur J Trauma Emerg Surg 34(6):554–560CrossRef Steiner CL, Trentz O, Labler L (2008) Management of Morel-Lavallee lesion associated with pelvic and/or acetabular fractures. Eur J Trauma Emerg Surg 34(6):554–560CrossRef
11.
Zurück zum Zitat Tseng S, Tornetta P 3rd (2006) Percutaneous management of Morel-Lavallee lesions. J Bone Jt Surg Am 88(1):92–96CrossRef Tseng S, Tornetta P 3rd (2006) Percutaneous management of Morel-Lavallee lesions. J Bone Jt Surg Am 88(1):92–96CrossRef
12.
Zurück zum Zitat Hak DJ, Olson SA, Matta JM (1997) Diagnosis and management of closed internal degloving injuries associated with pelvic and acetabular fractures: the Morel-Lavallee lesion. J Trauma 42(6):1046–1051PubMedCrossRef Hak DJ, Olson SA, Matta JM (1997) Diagnosis and management of closed internal degloving injuries associated with pelvic and acetabular fractures: the Morel-Lavallee lesion. J Trauma 42(6):1046–1051PubMedCrossRef
13.
Zurück zum Zitat Carlson DA, Simmons J, Sando W, Weber T, Clements B (2007) Morel-lavalee lesions treated with debridement and meticulous dead space closure: surgical technique. J Orthop Trauma 21(2):140–144PubMedCrossRef Carlson DA, Simmons J, Sando W, Weber T, Clements B (2007) Morel-lavalee lesions treated with debridement and meticulous dead space closure: surgical technique. J Orthop Trauma 21(2):140–144PubMedCrossRef
14.
Zurück zum Zitat Harma A, Inan M, Ertem K (2004) The Morel-Lavallee lesion: a conservative approach to closed degloving injuries. Acta Orthop Traumatol Turc 38(4):270–273PubMed Harma A, Inan M, Ertem K (2004) The Morel-Lavallee lesion: a conservative approach to closed degloving injuries. Acta Orthop Traumatol Turc 38(4):270–273PubMed
15.
Zurück zum Zitat Mukherjee K, Perrin SM, Hughes PM (2007) Morel-Lavallee lesion in an adolescent with ultrasound and MRI correlation. Skelet Radiol 36(Suppl 1):S43–45CrossRef Mukherjee K, Perrin SM, Hughes PM (2007) Morel-Lavallee lesion in an adolescent with ultrasound and MRI correlation. Skelet Radiol 36(Suppl 1):S43–45CrossRef
16.
Zurück zum Zitat Demirel M, Dereboy F, Ozturk A, Turhan E, Yazar T (2007) Morel-Lavallee lesion. Results of surgical drainage with the use of synthetic glue. Saudi Med J 28(1):65–67PubMed Demirel M, Dereboy F, Ozturk A, Turhan E, Yazar T (2007) Morel-Lavallee lesion. Results of surgical drainage with the use of synthetic glue. Saudi Med J 28(1):65–67PubMed
17.
Zurück zum Zitat Luria S, Applbaum Y, Weil Y, Liebergall M, Peyser A (2006) Talc sclerodhesis of persistent Morel-Lavallee lesions (posttraumatic pseudocysts): case report of 4 patients. J Orthop Trauma 20(6):435–438PubMedCrossRef Luria S, Applbaum Y, Weil Y, Liebergall M, Peyser A (2006) Talc sclerodhesis of persistent Morel-Lavallee lesions (posttraumatic pseudocysts): case report of 4 patients. J Orthop Trauma 20(6):435–438PubMedCrossRef
18.
Zurück zum Zitat Labler L, Trentz O (2007) The use of vacuum assisted closure (VAC) in soft tissue injuries after high energy pelvic trauma. Langenbecks Arch Surg 392(5):601–609PubMedCrossRef Labler L, Trentz O (2007) The use of vacuum assisted closure (VAC) in soft tissue injuries after high energy pelvic trauma. Langenbecks Arch Surg 392(5):601–609PubMedCrossRef
19.
Zurück zum Zitat Kohler D, Pohlemann T (2011) Operative treatment of the peri-pelvic Morel-Lavallee lesion. Oper Orthop Traumatol 23(1):15–20PubMedCrossRef Kohler D, Pohlemann T (2011) Operative treatment of the peri-pelvic Morel-Lavallee lesion. Oper Orthop Traumatol 23(1):15–20PubMedCrossRef
20.
Zurück zum Zitat Phillips TJ, Jeffcote B, Collopy D (2008) Bilateral Morel-Lavallee lesions after complex pelvic trauma: a case report. J Trauma 65(3):708–711PubMedCrossRef Phillips TJ, Jeffcote B, Collopy D (2008) Bilateral Morel-Lavallee lesions after complex pelvic trauma: a case report. J Trauma 65(3):708–711PubMedCrossRef
21.
Zurück zum Zitat Tran W, Foran J, Wang M, Schwartz A (2008) Postsurgical bleeding following treatment of a chronic Morel-Lavallee lesion. Orthopedics 31(8):814PubMedCrossRef Tran W, Foran J, Wang M, Schwartz A (2008) Postsurgical bleeding following treatment of a chronic Morel-Lavallee lesion. Orthopedics 31(8):814PubMedCrossRef
22.
Zurück zum Zitat Suzuki T, Hak DJ, Ziran BH, Adams SA, Stahel PF, Morgan SJ, Smith WR (2009) Outcome and complications of posterior transiliac plating for vertically unstable sacral fractures. Injury 40(4):405–409PubMedCrossRef Suzuki T, Hak DJ, Ziran BH, Adams SA, Stahel PF, Morgan SJ, Smith WR (2009) Outcome and complications of posterior transiliac plating for vertically unstable sacral fractures. Injury 40(4):405–409PubMedCrossRef
Metadaten
Titel
Efficacy of treatment in peri-pelvic Morel–Lavallee lesion: a systematic review of the literature
verfasst von
Chao Shen
Jian-Ping Peng
Xiao-Dong Chen
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 5/2013
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-013-1703-z

Weitere Artikel der Ausgabe 5/2013

Archives of Orthopaedic and Trauma Surgery 5/2013 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.