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一名足球运动员胫前肌疝的双层修复:病例报告及文献综述

Double layer repair of tibialis anterior muscle hernia in a soccer player: a case report and review of the literature.

作者信息

Dönmez Gürhan, Evrenos Mustafa Kürsat, Cereb Meryem, Karanfil Yigitcan, Doral Mahmut Nedim

机构信息

Department of Sports Medicine, Hacettepe University, Ankara, Turkey.

Department of Plastic and Reconstructive Surgery, SehitKamil State Hospital, Gaziantep, Turkey.

出版信息

Muscles Ligaments Tendons J. 2016 Feb 13;5(4):331-4. doi: 10.11138/mltj/2015.5.4.331. eCollection 2015 Oct-Dec.

Abstract

BACKGROUND

muscle herniations usually present in athletes especially in the lower legs; occurring through defects in the deep fascial layer of the muscles and typically seen following local blunt trauma or muscle hypertrophy after strenuous exercise. Management of muscle hernias varies from conservative therapy to surgical repair and usually needs multidisciplinary collaboration for differential diagnosis.

METHODS

herein tibialis anterior muscle hernia in 17-year-old male soccer player was presented. The diagnosis was confirmed with dynamic ultrasonographic views changing with the different movements of the ankle. Since the symptoms were not relieved with conservative methods, surgical repair of the defect was offered.

RESULTS

we preferred to repair fascial defect with double layer and Mesh graft that were placed over primary suture repair. No complications were reported such as wound or mesh infection postoperatively. The patient was clinically satisfied and returned his previous activity level after 3 months of surgery. After 2 years of follow-up the feature of the bulge was dissolved and player was satisfied with the operation.

CONCLUSION

knowledge of the lower extremity muscle herniation is essential for both proper management and/or surgical referral. The importance of protective devices in prevention, dynamic ultrasonography in diagnosis and double layer repair of the fascial defect with Mesh graft in treatment of muscle herniations were highlighted.

摘要

背景

肌肉疝通常出现在运动员身上,尤其是小腿部位;它通过肌肉深筋膜层的缺损形成,通常在局部钝性创伤或剧烈运动后肌肉肥大后出现。肌肉疝的治疗方法从保守治疗到手术修复不等,通常需要多学科协作进行鉴别诊断。

方法

本文介绍了一名17岁男性足球运动员的胫前肌疝。通过踝关节不同运动时动态超声图像的变化确诊。由于保守治疗方法未能缓解症状,因此对缺损进行了手术修复。

结果

我们倾向于用双层和补片移植修复筋膜缺损,补片置于初次缝合修复之上。术后未报告伤口或补片感染等并发症。患者临床满意,术后3个月恢复到之前的活动水平。随访2年后,肿块特征消失,患者对手术满意。

结论

了解下肢肌肉疝对于正确管理和/或手术转诊至关重要。强调了防护装置在预防中的重要性、动态超声在诊断中的重要性以及用补片移植双层修复筋膜缺损在治疗肌肉疝中的重要性。

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引用本文的文献

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Soft tissue pseudotumours: a pictorial review with emphasis on MRI.软组织假瘤:以磁共振成像为重点的影像综述
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本文引用的文献

1
An interesting case of post traumatic tibialis anterior muscle herniation.一例有趣的创伤后胫前肌疝病例。
Kathmandu Univ Med J (KUMJ). 2013 Oct-Dec;11(44):332-4. doi: 10.3126/kumj.v11i4.13478.
6
[Anterior tibial muscle hernia--reconstruction with periosteal patch plasty].
Vojnosanit Pregl. 2009 Dec;66(12):1015-8. doi: 10.2298/vsp0912015m.
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Tibialis anterior muscle herniation developed after trauma.
Int J Dermatol. 2008 Aug;47(8):845-7. doi: 10.1111/j.1365-4632.2008.03640.x.
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Bilateral muscle hernias of the anterior tibial muscle.
Foot Ankle Int. 2007 Apr;28(4):520. doi: 10.3113/FAI.2007.0520.
10
Painful bilateral herniation of the anterior tibial muscle: a case report.
Foot Ankle Int. 2006 Jul;27(7):552-5. doi: 10.1177/107110070602700712.

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