A Morel-Lavallee lesion (MLL) is a benign cystic lesion that occurs due to injury to the soft-tissue envelope's perforating vascular and lymphatic systems, resulting in a distinctive hemolymphatic fluid accumulation between the tissue layers. The MLL has the potential to make a significant impact on the treatment of orthopaedic injuries. A 79-year-old male patient community ambulatory with assisting aid (cane) known case of Diabetes mellitus, hypertension, bronchial asthma and ischemic heart disease. He was brought to the Emergency, complaining of right hip discomfort and burning sensation for the last 5 days with no history of recent trauma at all. Patient had history of right trochanteric femur fracture 3 years ago, treated with DHS in a privet service. Clinical and Radiological assessment showed that the patient mostly has acute MLL due to lag screw cut out. We offered the patient the surgical intervention, but he refused despite explaining the risks of complications if not treated and preferred to receive the conservative treatment. Compression therapy management explained to him including biker's shorts (instructed to be worn full-time a day) and regular follow up in clinic. Symptom's improvement was reported by the patient in the subsequent visits. In the polytrauma patient, a delayed diagnosis of these lesions is conceivable due to the presence of more visible injuries. It's located over the greater trochanter more commonly, but sometimes in other areas such as the lower lumbar region, the thigh, or the calf. Incorrect or delayed diagnosis and care can have unfavorable outcomes such as infection, pseudocyst development, and cosmetologically deformity. Magnetic resonance imaging (MRI) and ultrasound will aid in MLL diagnosis. However, the effectiveness of MLL therapy remains debatable. We strongly believe that the MLL caused due to tangential shear forces applied to the soft tissue leads to accumulation of the blood and/or lymph between the subcutaneous and overlying fascia and it often misdiagnosed due to other distracting injuries. Nontheless, in our case we reported MLL occur due to internal pressure on the fascia caused by cut out of DHS lag screw.
Acetabular morphology and orientation differs from ethnic group to another. Thus, investigating the normal range of the parameters that are used to assess both was a matter of essence. Nevertheless, the main aim of this study was clarification the relationship between acetabular inclination (AI) and acetabular and femoral head arcs’ radii (AAR and FHAR). A cross-sectional retrospective study that had been done in a tertiary center where Computed tomography abdomen scouts’ radiographs of non-orthopedics patients were included. They had no history of pelvic or hips’ related symptoms or fractures in femur or pelvis. A total of 84 patients was included with 52% of them were females. The mean of age was 30.38± 5.48. Also, Means of AI were 38.02±3.89 and 40.15±4.40 (P 0.02, significant gender difference) for males and females, respectively. Nonetheless, Head neck shaft angle (HNSA) means were 129.90±5.55 and 130.72±6.62 for males and females, respectively. However, AAR and FHAR means for males and females were 21.3±3.1mm, 19.9±3.1mm, P 0.04 and 19.7±3.1mm, 18.1±2.7mm, P 0.019, respectively. In addition, negative significant correlations were detected between AI against AAR, FHAR, HNSA and body mass index (BMI) (r 0.529, P ≤0.0001, r 0.445, P ≤0.0001, r 0.238, P 0.029, r 0.329, P ≤0.007, respectively). On the other hand, high BMI was associated with AAR and FHAR (r 0.577, P 0.0001 and r 0.266, p 0.031, respectively). This study shows that high AI is correlated with lower AAR, FHAR. Each ethnic group has its own normal values that must be studied to tailor the path for future implications in clinical setting.
