Morel-Lavallee lesion in orthopaedic surgery (Nineteen cases)

Aims. - The object of this work is the study of especially ancient clinical forms of the effusion of Morel-Lavallee, to discuss the place of deep fascial fenestration by Ronceray and to propose criteria of therapeutic indication. Patients and method. - Our study concerns a continuous retrospective series over 20 years from 1989 till 2009. Eleven men and eight women, 36.7 year-old on average were treated for an effusion of Morel-Lavallee. The dominant etiology was represented by the accidents of the public highway. The collection was discovered after 41.4 days on average (extremes of 1-180 days). The volume of the collection was on average of 1237 cm(3) (extremes 60 cm(3)-12 L). Results. - The conservative treatment concerned all patients who had a recent collection lower than three weeks and three others who had an ancient collection. The surgical treatment was established after all 10 times among which four in first intention and six times after failure of the previous treatment. The cure was obtained in 91% of the patients who had a recent collection by the only conservative method and among four patients by the method of Ronceray. To the three others, it was obtained after iterative unbridlings and talcage treatment. Conclusion. - The authors insist on certain rare forms met in Africa in particular the "virtual form'', the ancient forms and the too plentiful forms (12 L). They plead for use deep fascial fenestrations by Ronceray for these last ones. (C) 2010 Elsevier Masson SAS. All rights reserved.