Case Report| Volume 49, ISSUE 5, P488.e5-488.e9, September 2010

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Surgical Repair of Abductor Hallucis Muscle Herniation: A Case Report


      Herniation of the abductor hallucis muscle has rarely been reported in the literature. This condition causes localized pain, especially while weight bearing, as a result of a complex cascade of biomechanical events directly related to loss of integrity of the medial wall of the foot. The authors present a case of a flexor retinaculum tear with subsequent herniation of the abductor hallucis muscle. When conservative treatment options failed to provide significant relief, surgical intervention was performed, which revealed ischemic muscle tissue and a partial flexor retinaculum tear. The nonviable muscle was surgically debrided and the fascial defect was repaired with a polypropylene nonabsorbable synthetic surgical mesh. This herniorrhaphy reestablished medial compartment support, thus allowing the patient to return to pain-free ambulation.

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        • Rutkow I.M.
        • Robbins A.W.
        Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States.
        Surg Clin North Am. 1993; 73: 413
        • Sarrafian S.K.
        Retaining systems and compartments.
        in: Sarrafian S.K. Anatomy of the Foot and Ankle. Lippincott, Philadelphia1983: 119-120
        • Galinski A.W.
        Unusual etiology of a foot hernia: a case report.
        J Am Podiatr Med Assoc. 1972; 62: 26-28
        • Mueller T.J.
        • Bowlus T.H.
        Abductor hallucis myocele: a discussion and case presentation.
        J Am Podiatry Assoc. 1981; 71: 333-337
        • Browne H.S.
        Ischemic necrosis of muscle (acute anterior compartment syndrome) following repair of anterior compartment muscle hernias.
        R I Med J. 1968; 51: 620-621
        • McCain L.
        • Galinski A.W.
        Herniorrhaphy of the foot: a case report.
        J Am Podiatr Med Assoc. 1968; 58: 516-517
        • McMaster P.E.
        Muscle hernia of the leg: a study of 21 cases and 38 hernias.
        US Naval Med Bull. 1943; 41: 404-409
        • Bendavid R.
        The unified theory of hernia formation.
        Hernia. 2004; 8: 171-176
        • Rodrigues Jr., A.J.
        • Rodrigues C.J.
        • da Cunha A.C.
        • Jin Y.
        Quantitative analysis of collagen and elastic fibers in the transversalis fascia in direct and indirect inguinal hernia.
        Rev Hosp Clin Fac Med Sao Paulo. 2002; 57: 265-270
        • Braustein J.T.
        • Cures III, J.V.
        Magnetic resonance imaging of hereditary hernias of the peroneus longus muscle.
        Skeletal Radiol. 1995; 24: 601-614
        • Idhe H.
        On muscular hernia of leg.
        Ada Chir Scand. 1929; 65: 97-120
        • Rodrigues Jr., A.J.
        • de Tolosa E.M.
        • de Carvalho C.A.
        Electron microscopic study on the elastic and elastic related fibres in the human fascia transversalis at different ages.
        Gegenbaurs Morphol Jahrb. 1990; 136: 645-652
        • Cannon D.J.
        • Read R.C.
        Metastatic emphysema: a mechanism for acquiring inguinal herniation.
        Ann Surg. 1981; 194: 270-278
        • Galinski A.W.
        J Am Podiatry Assoc. 1978; 67: 646-650
        • Almdahl S.M.
        • Due Jr., J.
        • Samdal F.A.
        Compartment syndrome with muscle necrosis following repair of hernia of tibialis anterior: case report.
        Acta Chir Scand. 1987; 153: 695
        • Wolfort G.F.
        • Mogelvang C.
        • Filtzer H.S.
        Anterior compartment syndrome following muscle hernia repair.
        Arch Surg. 1973; 106: 97-99
        • Miniaci A.
        • Robabeck C.H.
        Tibialis anterior muscle hernia: a rationale for treatment.
        Can J Surg. 1987; 30: 79-80
        • Bloem J.J.
        The treatment of muscle hernias by fascial splitting.
        Br J Plast Surg. 1976; 29: 291-294
        • Richards H.
        • Thomas R.
        • Upadhyay S.S.
        Polypropylene mesh repair of iatrogenic thigh hernias.
        Injury. 1998; 29: 478
        • Siliprandi L.
        • Martini G.
        • Chiarelli A.
        • Mazzoleni F.
        Surgical repair of an anterior tibialis muscle hernia with Mersilene mesh.
        Plast Reconstr Surg. 1993; 91: 154-157
        • Marques A.
        • Brenda E.
        • Amarante M.T.
        Bilateral multiple muscle hernias of the leg repaired with Marlex mesh.
        Br J Plast Surg. 1994; 47: 444-446
        • Anthony Jr., J.E.
        Use of Marlex mesh in the repair of muscle hernias of the leg: case report.
        Am Surg. 1965; 31: 570
        • Golshani S.D.
        • Lee C.
        • Sydorak R.
        Symptomatic forearm muscle hernia: repair by autologous fascia lata inlay.
        Ann Plast Surg. 1999; 43: 204-206
        • Zeiss J.
        • Ebraheim N.A.
        • Woldenberg L.S.
        Magnetic resonance imaging in the diagnosis of anterior tibialis muscle herniation.
        Clin Orthop. 1989; 244: 249-253
        • Bianchi S.
        • Abdelwahab I.F.
        • Mazzola C.G.
        • Ricci G.
        • Damiani S.
        Sonographic examination of muscle herniation.
        J Ultrasound Med. 1995; 14: 357-360
        • Bastes D.G.
        Dynamic ultrasound findings of bilateral anterior tibialis muscle herniation in a pediatric patient.
        Pediatr Radiol. 2001; 31: 753-755