# Chronic Morel‐Lavallée Lesion Treated With Percutaneous Ultrasonic Debridement

## TL;DR

A new minimally invasive treatment using ultrasonic debridement successfully managed a long-standing Morel-Lavallée lesion in a patient.

## Contribution

The paper presents a novel application of the Tenex device for treating chronic Morel-Lavallée lesions.

## Key findings

- Percutaneous ultrasonic debridement effectively treated a 10-year-old Morel-Lavallée lesion.
- The Tenex device offers a minimally invasive alternative to conventional surgery for chronic cases.
- The treatment successfully disrupted and removed calcifications associated with the lesion.

## Abstract

Morel‐Lavallée lesion is defined as an internal degloving injury. A trauma involving shearing forces causes separation of the superficial fascia from the overlying subcutaneous tissue and skin, creating a potential space for hemolymphatic fluid to accumulate. This leads to the development of a self‐resolving or potentially chronic collection. Classically, lesions arise in the lateral thigh. Imaging features depend on the duration of the lesion. Acutely, ultrasound and MR imaging will demonstrate a hematoma‐like mass that is parallel to the underlying fascia. As the lesion evolves over time, calcifications with a dense capsule can form. Patients typically present with a persistent, localized swelling and pain that may radiate throughout the thigh. Initially, conservative therapy can be efficient; however, once a capsule forms, surgical management is the current gold standard therapy. Tenex (Tenex Health, Lake Forest, CA) is a device that uses high‐frequency ultrasonic waves to perform percutaneous debridement to disrupt and remove calcifications in the setting of various chronic musculoskeletal conditions. This case describes the successful use of this technology in a 68‐year‐old female with a 10‐year history of a Morel‐Lavallée lesion. Treatment of Morel‐Lavallée lesions using the Tenex device is a feasible, minimally invasive alternative to conventional surgery.

This case describes the use of Tenex in a 68‐year‐old female with a 10‐year history of a Morel‐Lavallée lesion. The device uses high‐frequency ultrasonic waves that percutaneously debride dystrophic musculoskeletal calcifications. Percutaneous ultrasonic debridement is a minimally invasive intervention to be considered for managing symptoms associated with chronic Morel‐Lavallée lesions.