Forearm muscle herniae and their treatment

Abstract

Three cases of forearm muscle hernia are described. Their aetiology differed but, in all three, symptoms were sufficiently severe to interfere with the patient's work. Surgical repair of the myocoeles, by closure of the fascial defects using lata onlay grafts or an interweave of palmaris longus tendon, produced complete resolution of symptoms and enabled the patients to return to full employment.

Forearm muscle hernia: a case report

“…There have been only 11 previous reports in the literature describing forearm muscle hernias [1]. A number of different techniques have been advocated for the management of this condition, including proximal and distal fasciotomies, palmaris longus interweave and fascia lata onlay graft [2,3].…”

Treatment of a symptomatic forearm muscle herniation with a wrap-around fascia lata graft

“…For this reason a formal fasciotomy had been advocated as the treatment of choice for symptomatic muscle hernia in the past [1]. However, the results of fasciotomy in the upper limb do not seemed to be as predictable as in the lower limb.…”

“…It was aggravated by gripping, especially with the index and middle fingers, and by cold weather but relieved with rest and immersing in warm water or after a hot bath/shower. Because of this [4] Synthetic mesh (polyester) [3] Fascia lata weave [1] Fascia lata onlay graft [1,6] Fascia lata inlay graft [7] Periosteal flaps [1] Botulinum toxin injection [2] he avoided using his left hand even at home and was not able to pursue his hobby of riding his motorbike. Occasionally the pain disturbed his sleep.…”

“…The first description for the condition was probably by Dupuytren in 1839 [1]. Over 200 cases have been reported in the literature since then.…”

“…The surgical treatment of symptomatic muscle hernias in the lower limb is still controversial with many different methods being described in the literature (Table 2) [1,2], while treatment options for muscle hernias the upper limb has also been varied (Table 1). To our knowledge, this report is the first on the use of a wrap-around fascia lata graft to treat this condition.…”