J Korean Fract Soc.  2019 Apr;32(2):102-106. 10.12671/jkfs.2019.32.2.102.

Surgical Repair of Tibialis Anterior Muscle Herniation Using a Synthetic Mesh That Was Beneath the Fascia after a Military Training Program: A Case Report

• Kim KH
• Shin YS

• KMID: 2443112
• DOI: http://doi.org/10.12671/jkfs.2019.32.2.102

Abstract

Tibialis anterior muscle herniation is the most common type of skeletal muscle herniation of the lower legs. The treatment of muscle herniation relies on the patient's symptoms. For patients with chronic large fascial defects, fascial grafting with synthetic mesh can be considered. In this case of a patient who was exposed to excessive strain on his lower legs during a military training program, the use of a secure repair technique with synthetic mesh was required. This paper presents a case of tibialis anterior muscle herniation that was treated successfully with a monofilament knitted polypropylene mesh covered by the tibialis anterior fascia. The advantages of this technique include early rehabilitation and an early return to work. No significant difference in the clinical results compared to other methods were observed and there were no complications. The military training program appeared to have aggravated the patient's symptoms of tibialis anterior muscle herniation. On the other hand, larger scale study will be needed to determine if this program actually affects the clinical outcomes.

Keyword

Mesh; Fascial grafting; Muscle herniation; Tibialis anterior muscle

MeSH Terms

Education*
Fascia*
Hand
Humans
Leg
Military Personnel*
Muscle, Skeletal
Polypropylenes
Rehabilitation
Return to Work
Transplants
Polypropylenes

Figure

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  Fig. 1 Clinical photograph of the mass over the right leg.

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  Fig. 2 Magnetic resonance imaging axial cut showing herniation of muscle through the fascia.

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  Fig. 3 Intraoperative photo showing a fascial defect with herniating muscle of the right leg.

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  Fig. 4 Intraoperative photograph of polypropylene non-absorbable synthetic surgical mesh.

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  Fig. 5 Intraoperative photo showing the fascial defect and the mesh beneath the fascia.

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  Fig. 6 Intraoperative photograph showing the fascial defect covered with polypropylene non-absorbable synthetic surgical mesh beneath the fascia.

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  Fig. 7 Three-month follow-up magnetic resonance imaging scan showing well repaired fascial defect using synthetic Mesh.

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