A Case of Forearm Muscle Herniation after Radial Forearm Sensory Tendocutaneous Free Flap.

Lee, Paik Kwon; Kim, Min Cheol; Jun, Young Joon; Oh, Deuk Young; Rhie, Jong Won; Ahn, Sang Tae

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(2):205-207.
Published online March 1, 2008.

A Case of Forearm Muscle Herniation after Radial Forearm Sensory Tendocutaneous Free Flap.

Paik Kwon Lee, Min Cheol Kim, Young Joon Jun, Deuk Young Oh, Jong Won Rhie, Sang Tae Ahn

Department of Plastic Surgery, College of Medicine, The Catholic University of Korea. psdoc@korea.com

Abstract

PURPOSE
Although muscle hernia has been well described in the lower-extremity, muscle hernias in the upper extremity are extremely rare. As with lower extremity muscle hernias, the forearm muscle hernia may result from forced exertion of strenuous activity or following blunt trauma. The objective of this paper is to report an extraordinary case of forearm muscle hernia after radial forearm sensory tendocutaneous free flap with references. METHODS: A 58-year-old male patient received wide excision and radical neck dissection and lower lip reconstruction with radial forearm sensory tendocutaneous free flap for squamous cell cancer on the lower lip. 16 weeks after the operation, he complained of protruding mass on the forearm and the size was increasing. In postoperative 18 weeks, MRI showed herniation of flexor digitorum superficialis. For unaesthetic cause and preventing progress, the authors performed direct fascial closure and Mesh graft.
RESULTS
In 12 months after the surgery there was no recurrence and the patient remained symptom-free.
CONCLUSION
Pain on extremity exertion and unaesthetic buldge of forearm due to forearm muscle hernia were the primary indications for surgery which consist of direct closure, fasciotomy, fascia lata onlay graft, fascia lata inlay graft, etc. The authors experienced uncommon forearm muscle hernia after radial forearm free flap and satisfying result of treatment.

Keywords: Muscle hernia; Radial forearm free flap