# Endoscopic Management of a Refractory Thigh Morel-Lavallée Lesion

## TL;DR

This paper describes a successful endoscopic treatment for a difficult thigh injury caused by trauma, avoiding complications and promoting faster recovery.

## Contribution

The paper introduces an endoscopic approach with pseudocapsulectomy and fibrin glue for refractory Morel-Lavallée lesions.

## Key findings

- Endoscopic debridement with fibrin glue resolved a refractory thigh Morel-Lavallée lesion.
- Six-month MRI follow-up showed complete resolution with no recurrence.
- The method reduces complications like skin necrosis compared to open surgery.

## Abstract

Morel-Lavallée lesions (MLLs) are post-traumatic closed degloving injuries characterized by the separation of skin and hypodermis from the underlying deep fascia, leading to the formation of fluid-filled cavities. We present the case of a 37-year-old male with a refractory distal thigh MLL sustained in a motor vehicle collision. After failed conservative management (aspiration and compression), the patient underwent endoscopic debridement with pseudocapsulectomy, drainage, and fibrin glue injection. Follow-up MRI at six months confirmed complete resolution with no recurrence. This approach combines the benefits of minimally invasive surgery, augmented with sclerotherapy, reducing the risk of complications, such as skin necrosis, when compared to open techniques because there is less recurrent aggression and promoting a faster recovery. While endoscopic techniques show promise for MLLs at high risk of wound complications, comparative studies are needed to establish optimal treatment algorithms.