This narrative review covers the pathophysiology, imaging classification, and treatment decision-making for Morel-Lavallée lesions (MLLs) — closed hemolymphatic degloving injuries caused by shear forces separating the hypodermis from the underlying fascia. It addresses how to identify these lesions in polytrauma patients and how to choose among observation, aspiration, and open débridement.
When you see a peritrochanteric or pelvic soft-tissue fluctuance after high-energy trauma — especially with an acetabular fracture — get CT or MRI to characterize the MLL before operating: a lesion adjacent to your planned incision warrants débridement and drain placement first, because percutaneous aspiration alone carries a >50% recurrence rate and the fluid is colonized in nearly half of cases.
This narrative review covers the pathophysiology, imaging classification, and treatment decision-making for Morel-Lavallée lesions (MLLs) — closed hemolymphatic degloving injuries caused by shear forces separating the hypodermis from the underlying fascia. It addresses how to identify these lesions in polytrauma patients and how to choose among observation, aspiration, and open débridement.
When you see a peritrochanteric or pelvic soft-tissue fluctuance after high-energy trauma — especially with an acetabular fracture — get CT or MRI to characterize the MLL before operating: a lesion adjacent to your planned incision warrants débridement and drain placement first, because percutaneous aspiration alone carries a >50% recurrence rate and the fluid is colonized in nearly half of cases.