The Morel-Lavallée Lesion as a Rare Differential Diagnosis for Recalcitrant Bursitis of the Knee: Case Report and Literature Review

A 72 year-old-male was referred to our institution with recalcitrant prepatellar bursitis. The injury was sustained after striking his right knee against a post whilst horse riding 9 months ago. Previous treatments included repeated aspiration and excision of the bursa with elastic compression bandaging. A diagnosis of a Morel-Lavallée internal degloving injury was made, and the lesion was satisfactorily managed by an internal quilting procedure to eliminate the potential dead space. A review of the literature reveals 29 published reports of Morel-Lavallée lesions with sufficient information for inclusion. These came from 14 separate countries with a total of 204 lesions in 195 patients. The most common anatomical location was the greater trochanter/hip (36%), followed by the thigh (24%) and the pelvis (19%). Most were managed surgically with evacuation of the haematoma and necrotic tissue followed by debridement, which was often repeated (36%). Conservative treatment with percutaneous aspiration and compression bandaging was the next most common treatment (23%). The knee was the fourth most common region affected (16%), and only 3 other lesions in the literature have been managed with a quilting procedure

The London 2012 Summer Olympic Games - an analysis of usage of the Olympic Village ‘Polyclinic’ by competing athletes

AbstractBackground The London 2012 Summer Olympic Games involved 10 568 elite athletes representing 204 competing nations. To manage the varied healthcare needs of this diverse population, a Polyclinic was constructed in the athletes’ village.Aim This work aims to summarise the usage of the Polyclinic by competing athletes and the facilities available to them.Methods All Polyclinic encounters were entered into a database from which data were exported for the time frame 28 July–12 August 2012, inclusive to cover the first to last full day of competition. Only Polyclinic data involving accredited athletes were analysed. All types of encounters were collected for analysis, not just sports-related issues.Results There were a total of 3220 encounters within the Polyclinic. This figure combines medical consultations, radiology/pathology investigations and prescriptions dispensed. Of these 3220 encounters, there were 2105 medical consultations; musculoskeletal comprised the greatest number (52%), followed by dental (30%) and ophthalmic (9%). The most frequently used imaging modality was MRI and diagnostic CT was used the least. After correction for multiple entries, Africa provided the largest proportion of athletes attending the Polyclinic (44%) and Europe the least (9%). Peak usage of all facilities was seen around days 9 and 10 of competition, reflecting the busiest time of the competition and the largest number of athletes in the village.Conclusions The Polyclinic managed a wide variety of both sports-related and non-sports-related injuries and illnesses. The breadth of specialists available for consultation was appropriate as was the ease of access to them. The radiology department was able to satisfy the demand, as were the pharmacy and pathology services. We would recommend a similar structure of facilities and available expertise in one clinic when planning future mass participation sporting events