Abstract
BackgroundMuscle herniation of the leg is a rare clinical entity. Yet, knowing this condition is necessary to avoid misdiagnosis and delayed treatment. In the extremities, muscle herniation most commonly occurs as a result of an acquired fascial defect, often due to trauma. Different treatment options for symptomatic extremity muscle herniation in the extremities, including conservative treatment, fasciotomy and mesh repair have been described.Case presentationWe present the case of a patient who presented with prolonged symptoms after an ankle sprain. The clinical picture showed a fascial insufficiency with muscle bulging under tension. Ultrasound and MRI imaging confirmed the diagnosis of muscle hernia of the medial gastrocnemius on the right leg. Conservative treatment did not lead to success. Therefore, the fascial defect was treated surgically by repairing the muscle herniation using a synthetic vicryl propylene patch.ConclusionsMuscle hernias should be taken into consideration as a rare differential diagnosis whenever patients present with persisting pain or soft tissue swelling after ankle sprain. Diagnosis is mainly based on clinical aspect and physical examination, but can be confirmed by radiologic imaging techniques, including (dynamic) ultrasound and MRI. If conservative treatment fails, we recommend the closure with mesh patches for large fascial defects.
Highlights
Muscle herniation of the leg is a rare clinical entity
Muscle hernias should be taken into consideration as a rare differential diagnosis whenever patients present with persisting pain or soft tissue swelling after ankle sprain
We recommend the closure with mesh patches for large fascial defects
Summary
We report the case of a 3 × 7 cm symptomatic fascial hernia after ankle sprain that was successfully surgically repaired by using a Vicryl-Propylene mesh. Potential muscle hernias have to be taken into differential diagnostic considerations in patients with persisting pain or swelling after distortions of the ankle joint. If a patient is not symptom-free under conservative treatment, surgical repair with mesh graft can be performed with relatively low-risk. Consent Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. Authors’ contributions GB participated in the clinical examinations and drafted the manuscript. BDC and CMLW were involved in the clinical examinations and the surgical procedures and revised the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests
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