CASE REPORT article
Front. Surg.
Sec. Reconstructive and Plastic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1639073
This article is part of the Research TopicUnder Pressure: Insights on negative pressure wound therapy in the emergency settingView all articles
Giant Morel-Lavallée Lesion Complicated with Open Pelvic Fracture: A Rare Case Report
Provisionally accepted
- 1China Academy of Chinese Medical Sciences Wangjing Hospital, Beijing, China
- 2Gansu Provincial People’s Hospital, Lanzhou, China
- 3Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
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Background: Morel-Lavallée lesion (MLL) is a rare closed degloving injury from high-energy shear/crush trauma, often linked to pelvic/acetabular fractures. Due to limited clinical awareness, it is highly prone to misdiagnosis, potentially causing severe complications like infection and skin necrosis. Existing literature rarely documents giant MLL with open pelvic fractures. This article reports such a case in an obese patient after heavy-object impact, aiming to enhance understanding and improve management of complex injuries.: A 27-year-old male sustained lumbosacral giant MLL and open pelvic fracture from workplace heavy-object crush. The MLL was unrecognized for two weeks at another hospital. Upon transfer, he had hemorrhagic shock, fluctuating lumbosacral swelling, and localized skin necrosis. Imaging showed comminuted left iliac fracture with extensive soft tissue edema and gas. Management: A three-stage surgery was used. Stage 1: muscle debridement, fracture fixation, and vacuum-assisted closure (VAC) to address acute injury and control infection. Stage 2: debridement, antibiotic-loaded bone cement implantation, and continued VAC for osteomyelitis treatment and bone healing. Stage 3: flap reconstruction and skin grafting to restore soft tissue integrity.The patient was discharged one month postoperatively with viable skin grafts. At 3-month follow-up, fracture and wound healed well, confirming the staged approach's effectiveness.MLL is often overlooked in high-energy trauma, emphasizing early comprehensive exams plus imaging to avoid misdiagnosis. For MLL with fractures, staged treatment is advisable: early radical debridement and VAC to control infection, followed by fixation and soft tissue reconstruction when stable. VAC reduces infection risk by minimizing exudation and promoting granulation. Obese patients, with loose adipose compartments, face higher MLL risk and need special attention.Future research should explore minimally invasive techniques to optimize outcomes.
Keywords: Morel-Lavallée lesion, open pelvic fracture, Misdiagnosis, case report, rare
Received: 01 Jun 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Li, Li, Luo, Chen and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangli Luo, Gansu Provincial People’s Hospital, Lanzhou, China
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