J Korean Fract Soc.  2012 Oct;25(4):331-334. 10.12671/jkfs.2012.25.4.331.

Anterior Tibial Muscle Hernia Treated with Local Periosteal Rotational Flap: A Case Report

• Lee JK
• Yoon HK
• Shin DE
• Kim JH
• Lee DH

• KMID: 1434076
• DOI: http://doi.org/10.12671/jkfs.2012.25.4.331

Abstract

Tibialis anterior muscle hernia is the most common hernia among lower extremity muscles. This condition can be diagnosed by physical examination and radiologic findings, especially by dynamic ultrasonography. There are surgical methods of treatment for muscle hernia, including direct repair, fasciotomy, fascial patch grafting using autologous fascia lata or synthetic mesh. We report a case of tibialis anterior muscle hernia treated with local periosteal rotational flap. Because there are several advantages to the local periosteal rotational flap, such as lack of donor site morbidity, lack of skin irritation, low cost, simplicity, and an easy approach, this technique could be an option for tibialis anterior muscle hernia.

Keyword

Muscle hernia; Tibialis anterior muscle; Periosteal flap

MeSH Terms

Fascia Lata
Hernia
Humans
Lower Extremity
Muscle, Skeletal
Muscles
Physical Examination
Skin
Tissue Donors
Transplants

Figure

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  Fig. 1 The mass is prominent in a squatting position.

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  Fig. 2 Dynamic transverse ultrasonography of left anterolateral lower leg. (A) Image of ankle plantarflexion. Mild tibialis anterior herniation is seen between the tibia (star) and discontinued fascia (arrow). (B) Image of ankle dorsiflexion. The muscle hernia is prominent and the diameter (d) of the defect portion between the tibia (star) and fascia (arrow) is about 2.4 cm.

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  Fig. 3 Fascial defect is seen after skin and subcutaneous incision.

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  Fig. 4 (A) A periosteal flap is made to repair the fascial defect. (B) Turning the graft over the defective portion.

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  Fig. 5 (A) The graft is sufficient to cover the defect, but a partial graft is remained. (B) The remaining periosteal portion is overlapped and sutured for augmentation.

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