#MYOFASCIA COMPARTMENTS OF LEG SERIES#
In 1929, Ihde reported a series of 12 patients about hernias of the leg and classified hernias as constitutional or traumatic. Spontaneous hernias, on the other hand, are considered a consequence of chronic stress exposure, including regular, vigorous physical exercise with consequent muscular hypertrophy and elevated intra-compartmental pressure. It is attributed to a penetrating injury or a herniation caused by overexertion or trauma of fascial muscle. Muscle herniation is suggested to be posttraumatic or spontaneous.
The patient has been undergoing a series of rehabilitation programs until now. The weakness of dorsiflexion of ankle joint was still noted, and the report of nerve conduction velocity electromyography revealed common peroneal nerve neuropathy with active denervation. The pain in lower leg pain was dramatically improved after fasciotomy and the muscle tone of extensor hallucis longus well recovered in 1 month after the procedure. įigure 3: A defect of fascia with 8 cm in length was noted above the tibialis anterior muscleįigure 4: The defect was repaired under primarily suture with 1-0 Vicrylįigure 5: Muscle necrosis was noted 48 h after previous operationĭuring the following 2 weeks, additional debridement with changing of the dressing was arranged until the dead tissue was adequately debrided and closure of wound without tension. The incision wound was opened with fasciotomy 48 h after surgery, and necrosis of tibialis anterior was noted. Although the vascular status was intact, weakness of dorsiflexion of ankle and swelled toe was noted. After 24 h of the operation, unexpectedly, the patient exhibited a severe and spontaneous pain over left lower leg. The muscle inflammation was not significant. The defect was repaired with primary suture under some tension. We found a defect of fascia with 8 cm in length and the muscle hernia of left tibialis anterior upon surgery. (b) The magnetic resonance imaging of fast spin-echo T2-weighted showed stranding over left tibialis anterior muscle and some fluid around the tendon sheath (Coronal plane) Given this result, the patient was diagnosed with a muscle hernia in the tibialis anterior, and surgical intervention was arranged.įigure 1: A palpable mass was noted over anterior compartment of left lower legįigure 2: (a) The magnetic resonance imaging of fast spin-echo T2-weighted showed stranding over left tibialis anterior muscle and some fluid around the tendon sheath (Axial plane). The magnetic resonance imaging of the lower leg obtained with fat suppression fast spin-echo T2-weighted sequence showed stranding over left tibialis anterior muscle and small amount of fluid around the tendon sheath. The mass of hernia increased with dorsiflexion of ankle and during standing, and a palpable defect of fascia was noted. Physical examination showed a mass located over anterior compartment of lower leg with local tenderness. Compartment syndrome is one of the serious complications of the treatment for a herniation of the tibialis anterior.Ī 20-year-old man presented with a 6-month history of sudden onset of pain and mass protrusion over the left lower leg.
When conservative management such as elastic support and restriction of exercise is ineffective, surgical treatment is necessarily required. Treatment is usually necessary for troublesome symptoms or for cosmetic reasons. It often creates a minor cosmetic problem and patients are usually asymptomatic, but may rarely complain of pain, cramps, or local tenderness after prolonged exertion in most severe cases. The most frequent muscle hernia of lower extremity is that of the tibialis anterior.
Muscle hernias through an overlying fascial defect most commonly occur in athletes or young adults, especially in athletes with occupations requiring excessive strain on the legs. Herniation of muscle is characterized by a focal muscular protrusion through an acquired or congenital defect in the deep fascia. Compartment Syndrome Following Directly Repair of Hernia of Anterior Tibialis
#MYOFASCIA COMPARTMENTS OF LEG HOW TO#
How to cite this URL: Li YT, Hung CC, Pan RY, Hua SY. How to cite this article: Li YT, Hung CC, Pan RY, Hua SY. Keywords: Muscle hernia, anterior tibialis, compartment syndrome, fasciotomy The sequelae as weakness of dorsiflexion of ankle and big toe were present. A fasciotomy was proceeded to complication of acute compartment syndrome developed after the operation. We performed a simple closure of fascial defect. Muscle herniation through a fascial defect is rare, which requires repair of fascial defects. We present a case of a patient with hernia of anterior tibialis who was treated operatively.
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