title: Double layer repair of tibialis anterior muscle hernia in a soccer player: a case report and review of the literature.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Sports Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Gürhan
authors.initials: G
authors.lastname: Dönmez
authors.affiliation: Department of Plastic and Reconstructive Surgery, SehitKamil State Hospital, Gaziantep, Turkey.
authors.forename: Mustafa Kürsat
authors.initials: MK
authors.lastname: Evrenos
authors.affiliation: Department of Radiology, State Hospital, Gaziantep, Turkey.
authors.forename: Meryem
authors.initials: M
authors.lastname: Cereb
authors.affiliation: Department of Sports Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Yigitcan
authors.initials: Y
authors.lastname: Karanfil
authors.affiliation: Department of Sports Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Mahmut Nedim
authors.initials: MN
authors.lastname: Doral
keywords: mesh graft; muscle herniation; shin guard; soccer; ultrasonography