Header

UZH-Logo

Maintenance Infos

Gastrocnemius muscle herniation as a rare differential diagnosis of ankle sprain: case report and review of the literature


Bergmann, Greta; Ciritsis, Bernhard D; Wanner, Guido A; Simmen, Hans-Peter; Werner, Clément Ml; Osterhoff, Georg (2012). Gastrocnemius muscle herniation as a rare differential diagnosis of ankle sprain: case report and review of the literature. Patient Safety in Surgery, 6:5.

Abstract

BACKGROUND: Muscle 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 PRESENTATION: We 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. CONCLUSIONS: 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. 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.

Abstract

BACKGROUND: Muscle 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 PRESENTATION: We 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. CONCLUSIONS: 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. 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.

Statistics

Citations

Altmetrics

Downloads

261 downloads since deposited on 04 Feb 2013
41 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:14 March 2012
Deposited On:04 Feb 2013 13:18
Last Modified:07 Dec 2017 18:46
Publisher:BioMed Central
ISSN:1754-9493
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1186/1754-9493-6-5
PubMed ID:22417228

Download

Download PDF  'Gastrocnemius muscle herniation as a rare differential diagnosis of ankle sprain: case report and review of the literature'.
Preview
Content: Published Version
Filetype: PDF
Size: 1MB
View at publisher
Licence: Creative Commons: Attribution 2.0 Generic (CC BY 2.0)