Abstract
BACKGROUND: Morel-Lavallée lesions (MLLs) are rare, post-traumatic, closed degloving injuries characterized by the separation of the skin and subcutaneous tissue from the underlying fascia, leading to fluid collection. This case study details the presentation, diagnosis, management, and outcomes of MLL in a 75-year-old obese male following a motor vehicle accident. CASE PRESENTATION: The patient presented with significant swelling on the right thigh, measuring 30 × 20 cm, associated with erysipelas, chronic kidney disease, hypertension, and recurrent urothelial carcinoma. Diagnostic imaging, including MRI, confirmed a large, encapsulated hemolymphatic fluid collection consistent with MLL. Management included intravenous antibiotics, multiple rounds of debridement, capsulectomy, and local flap reconstruction. Despite initial improvement, the patient experienced recurrent fluid accumulation and persistent wound healing complications. OUTCOME: Following additional surgical interventions, including gastrocnemius muscle flap reconstruction, the patient achieved satisfactory functional recovery and scar healing, with residual swelling managed via compression therapy. This case underscores the complexity of treating MLL in elderly patients with comorbidities and highlights the importance of a multidisciplinary approach in achieving favorable outcomes.