Bilateral multiple muscle hernias of the leg repaired with Marlex mesh

doi:10.1016/0007-1226(94)90076-0

British Journal of Plastic Surgery

Volume 47, Issue 6, 1994, Pages 444-446

https://doi.org/10.1016/0007-1226(94)90076-0 Get rights and content

Abstract

We report a case of multiple muscle hernias of the legs, resulting from regular, intense, physical exertion. The multiple fascial defects were closed with Marlex mesh. On review after 5 years, there were no recurrences of the hernias.

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Cited by (29)

Muscle herniae: Conservative and surgical management. Systematic review
2023, Surgeon
Citation Excerpt :
The constitutional form is usually related to a congenital weakness of the muscle fascia that promotes herniation. The acquired forms are often secondary to direct or indirect trauma.4,28,30,31 Repetitive traumas can progressively damage and weaken the fascia allowing herniation.1
Muscle herniae are often unrecognized. The primary objective of this systematic review is to evaluate the outcomes of conservative and surgical management for muscle herniae. The secondary objective is to define the most appropriate management for muscle herniae depending on aetiology and size of the fascial defect.
The PRISMA guidelines were used to organize this systematic review to assess the different management modalities and identify possible criteria useful to guide the management of muscle herniae. An electronic search of PubMed and Scopus databases was performed.
A total of 132 patients were identified. Conservative management was carried out in 22 (16.7%) patients, and 110 (83.3%) patients underwent surgical procedures. Pain was reported in 3/22 (13.6%) patients managed conservatively. Post-surgical pain was reported in 0/5 (0%) patients treated with autologous graft repair, 1/15 (6.7%) patient with mesh repair, 2/13 (15.4%) patients with direct repair and 11/77 (14.3%) patients with fasciotomy. Return to normal activity was possible in 16/22 (72.7%) patients treated conservatively, 5/5 (100%) patients undergoing autologous graft repair, 13/15 (86.7%) with mesh repair, 62/77 (80.52%) with fasciotomy and 4/12 (33.3%) with direct repair.
In congenital muscle herniae, fasciotomy should be considered the surgical choice to prevent complications. In post-traumatic muscle hernia, a small fascial defect can be treated with the direct suture repair, while mesh repair and autologous graft repair should be considered the most appropriate procedures to avoid severe complications such as compartment syndrome.
Primary Repair of Peroneus Longus Myofascial Herniation With Symptomatic Superficial Peroneal Nerve Compression
2023, Arthroscopy Techniques
Symptomatic myofascial herniations of the extremities occur infrequently; however, they can contribute to significant pain, weakness, and neuropathy with activity. Muscle herniation typically occurs through either a traumatic or congenital focal defect in the deep overlying fascia. Patients may present with an intermittently palpable subcutaneous mass and may have neuropathic symptoms, depending on the degree of nerve involvement. Patients are initially treated with conservative modalities, whereas surgery is reserved for patients who demonstrate persistent functional limitations and neurologic symptoms. Here, we demonstrate a technique for primary repair of a symptomatic lower-leg fascial defect.
Minimally invasive fasciotomy for symptomatic tibialis anterior muscle hernia
2023, Surgeon
Symptomatic muscle herniae are an uncommon cause of chronic exercise induced leg pain. The most common site for muscle hernia is the tibialis anterior muscle. This study evaluates the outcome of a minimal incision fasciotomy in patients with a symptomatic muscle hernia of the tibialis anterior muscle, and their return to normal daily activities including sport.
The study reports mid-term results in a series of 22 consecutive patients (17 males and 5 females, median age: 22 years) with a unilateral tibialis anterior MH who had undergone minimally invasive fasciotomy between 2008 and 2019. Clinical outcomes were assessed with SF-36 and European Quality of Life-5 Dimensions scale (EQ-5D). The ability to participate in sport before and after surgery, and the time to return to training (RTT) and to sport (RTS) were recorded.
At a median follow up after surgery of 23 months, both questionnaires showed a statistically significant improvement (P < 0.005). At the latest follow up, 16 of patients (73%) had returned to pre-injury or higher levels of sport/activity. The median time to return to training and to return to sport was 7 and 11 weeks respectively. No severe complications and no recurrence of symptoms were recorded.
Minimally invasive fasciotomy is effective and safe for patients suffering from muscle hernia of the tibialis anterior muscle with good results in the mid-term.
IV.
Transient leg nodules
2022, JAAD Case Reports
Tibialis anterior muscle hernia: A rare cause of leg pain. Case report and review of the literature
2020, Apunts Sports Medicine
Muscular hernias in the lower limb are a rare entity that have seldom been described in the literature, from 1929 about 200 cases of muscle hernias have been described.
Here, we present a case of tibialis anterior muscle hernia and discuss the aetiology behind the same. Furthermore, we attempt to amalgamate existing knowledge to provide some guidance for investigation and management of this important diagnostic consideration.
Lower limb hernias are rare but should be considered as a differential for unidentified lower limb swellings. There is no clear consensus in literature about treatment, so every case must be individualized.
Las hernias musculares son raras, donde se evidencian con más frecuencia son en las extremidades inferiores siendo el tibial anterior el músculo más afectado. En este artículo describimos un caso de hernia muscular de tibial anterior y su evolución clinica, además de revisión de la literatura actual sobre el tema.
Paciente de 34 años, albañil, que en contexto de accidente laboral (caida de 2 metros) presenta contusión en cara lateral de pierna derecha con diagnóstico de fractura de 1/3 medio de perone de pierna derecha, Paciente presenta buen curso clinico con consolidación completa de la fractura a los 3 meses de evolución, pero persistiendo dolor y aumento de volumen en cara anterior de la pierna. Se solicita resonancia magnética de pierna que es informada como normal. A la exploración en reposo nada a destacar, en bipedestación (Fig. 1) se observa masa palpable de 2 cm aprox en cara anteromedial de 1/3 medio de tibia de pierna derecha, que se reduce al pasar a decúbito supino. Se realiza ecografia dinámica con paciente en bipedestación y forzando dorsiflexión del pie, confirmándose hernia de músculo tibial anterior con disrupción parcia de su fascia, hernia de 11,7 mm de tamaño con 3 cm de extensión (Fig 2). Se realiza tratamiento conservador mediante tratamiento rehabilitador antiinflamatorio (magnetoterapia) + vendajes compresivos locales.
Paciente presenta buena evolución clinica presentando a los 4 meses de iniciado el tratamiento disminución de dolor y refiriendo ausencia de hernia, que se confirma a la exploración clinica. Paciente retorna a su actividad laboral sin incidencias.
Las hernias musculares son raras, su localización mas habitual es en extremidades inferiores. Son un diagnóstico de exclusión, que muchas veces pasa desapercibido (1) y pueden ser causa de dolor y aumento de volumen crónico unilateral en extremidad inferior.
Tibialis anterior muscle hernia: A clinical case presentation
2016, FMC Formacion Medica Continuada en Atencion Primaria

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Bilateral multiple muscle hernias of the leg repaired with Marlex mesh

Abstract

J Am Acad Dermatol

Br J Plast Surg

Tibialis anterior muscle hernia: a rationale for treatment

Can J Surg

Multiple muscle herniae

BMJ