A Morel-Lavallée lesion (MLL) is a rare injury caused by blunt force trauma causing separation of subcutaneous tissue from the deep fascia. It is frequently seen in orthopaedic cases involving fractures of the hip or pelvis but is rare in the lower leg. The rarity of this condition often leads to misdiagnosis. A 66-year-old man presented to the emergency department after a 300-pound safe sheered across his left anterolateral leg causing skin avulsion, tenderness, swelling, ecchymosis, and erythema. The patient was treated for suspected cellulitis with oral antibiotics, but the lesion evolved into a necrotic eschar necessitating surgical intervention. In hindsight, MLL is a more appropriate diagnosis based on injury mechanism, disease progression and intraoperative findings. A history of shearing trauma with diffuse ecchymosis and erythema should prompt consideration of MLL. Due to rampant misdiagnosis, this case aims to increase awareness, as early diagnosis of MLL will improve patient outcomes.
- emergency medicine
- general surgery
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Contributors KR, LB and JM: conceived the idea for this manuscript; made edits to the final revised draft. KR: wrote the initial first draft.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.