title: The Morel-Lavallée lesion revisited: management in spinopelvic dissociation.
abstract: BACKGROUND
  The Morel-Lavallée lesion occurs from a compression and shear force that usually separates the skin and subcutaneous tissue from the underlying muscular fascia. A dead space is created that becomes filled with blood, liquefied fat, and lymphatic fluid from the shearing of vasculature and lymphatics. If not treated appropriately, these lesions can become infected, cause tissue necrosis, or form chronic seromas.
  
  
  OBJECTIVE
  To review appropriate identification and treatment of Morel-Lavallée lesions in spinopelvic dissociation patients.
  
  
  METHODS
  Uncontrolled case series.
  
  
  METHODS
  Retrospective review of medical records. No funding was received in support of this study. The authors report no conflicts of interest.
  
  
  RESULTS
  We present four cases of patients with traumatic spinopelvic dissociation. All had concomitant lumbosacral Morel-Lavallée lesions. All four trauma patients suffered traumatic spinopelvic dissociation with concomitant lumbosacral Morel-Lavallée lesions. Appropriate treatment included irrigation and debridement, drainage, antibiotics, and vacuum-assisted wound closure.
  
  
  CONCLUSIONS
  Our series reflects an association of Morel-Lavallée lesion in spinopelvic dissociation trauma patients. Possibly, the rotatory injury that occurs at the spinopelvic junction creates a shear force to form the Morel-Lavallée lesion. When presented with a spinopelvic dissociation patient, one should be prepared to treat a Morel-Lavallée lesion.
authors.affiliation: Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 W. 10th Ave., Columbus, OH 43201, USA.
authors.forename: Shah Nawaz M
authors.initials: SN
authors.lastname: Dodwad
authors.affiliation: College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH 43210, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Niedermeier
authors.affiliation: Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 W. 10th Ave., Columbus, OH 43201, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yu
authors.affiliation: UW Orthopaedics and Sports Medicine, University of Washington, 1959 N.E. Pacific St., Box 356500, Seattle, WA 98195-6500, USA.
authors.forename: Tania A
authors.initials: TA
authors.lastname: Ferguson
authors.affiliation: Department of Orthopaedics, University of California at Davis Medical Center, 3301 C St., Suite 1500, Sacramento, CA 95816, USA.
authors.forename: Eric O
authors.initials: EO
authors.lastname: Klineberg
authors.affiliation: Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 W. 10th Ave., Columbus, OH 43201, USA. Electronic address: safdar.khan@osumc.edu.
authors.forename: Safdar N
authors.initials: SN
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D003646:Debridement; D019468:Disease Management; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D049291:Seroma / Q000000981:diagnostic imaging / Q000601:surgery*; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Infection; Morel-Lavallée lesion; Spine trauma; Spinopelvic disassociation