Double layer repair of tibialis anterior muscle hernia in a soccer player: a case report and review of the literature

Abstract

Background: muscle herniations usually present in athletes especially in the lower legs; occurring through defects in the deep fascial layer of the muscles and typically seen following local blunt trauma or muscle hypertrophy after strenuous exercise. Management of muscle hernias varies from conservative therapy to surgical repair and usually needs multidisciplinary collaboration for differential diagnosis. Methods: herein tibialis anterior muscle hernia in 17-year-old male soccer player was presented. The diagnosis was confirmed with dynamic ultrasonographic views changing with the different movements of the ankle. Since the symptoms were not relieved with conservative methods, surgical repair of the defect was offered. Results: we preferred to repair fascial defect with double layer and Mesh graft that were placed over primary suture repair. No complications were reported such as wound or mesh infection postoperatively. The patient was clinically satisfied and returned his previous activity level after 3 months of surgery. After 2 years of follow-up the feature of the bulge was dissolved and player was satisfied with the operation. Conclusion: knowledge of the lower extremity muscle herniation is essential for both proper management and/or surgical referral. The importance of protective devices in prevention, dynamic ultrasonography in diagnosis and double layer repair of the fascial defect with Mesh graft in treatment of muscle herniations were highlighted.

Semimembranosus: A Rare Muscle Herniation and Review of the Literature

“…The relief of pain during the sixth postoperative week and the resumption of complete activity after the second month demonstrate that stability has been achieved and is coherent with the literature. The lack of recurrence in the long term and the disappearance of the pain alongside the regained functionality have been consistent with similar studies [20].…”

A Traumatic Neuroma Formation Following Fasciotomy for the Treatment of Tibialis Anterior Muscle Herniation: A Case Report

“…First, we presented a case of bilateral multiple TAMHs with traumatic neuromas of the SPN following fasciotomy. Several surgical procedures have been reported for the treatment of TAMH [ 2 , 4 , 5 , 6 , 7 , 8 , 15 ]. However, these previous studies were case series without high-level evidence, indicating no established surgical treatment for TAMHs.…”

“…When conservative treatments do not resolve the symptoms, surgical intervention is generally required. Available surgical options previously reported in academic papers include direct repair [ 4 ], repair using periosteum [ 5 ] or mesh [ 6 , 7 ] and fasciotomy [ 2 , 8 ]. These previous studies reported favorable clinical outcomes.…”

Periosteal Rotation Flap Technique in Management of Tibialis Anterior Muscle Hernia: A Case Series

“…A longitudinal fasciotomy has been recommended 7. Repair with synthetic patches has been implemented 8. Despite various techniques, no recurrence rate for the condition after surgical treatment has been reported in the literature.…”