Muscle Hernias in the Upper Limb: Treatment and Literature Review


      A muscle hernia is defined as a protrusion of the muscle belly through an acquired or congenital fascial defect. A nontraumatic herniation may occur through congenital fascial defects or be acquired by means of exertion, blunt trauma, or a penetrating injury. In this study, our aim was to review our experience with this rare condition and report the results of surgical treatment of these cases.


      During the period between January 1, 2014, and August 30, 2018, 12 cases of symptomatic muscle hernia in the upper limb were included in our study: 9 cases involving the forearm and 3 cases involving the arm. All patients underwent direct repair of their fascial defect with overlapping of the deep fascia using nonabsorbable sutures.


      There were improvements in postoperative pain, swelling, appearance, weakness, and paresthesia. There was significant improvement in the Disabilities of the Arm, Shoulder and Hand score from a mean of 51.8 before surgery to 6.9 after surgery. The mean period to return to activities of daily living was 18 days (range, 15–20 days).


      Muscle hernia in the upper limb is an uncommon condition that can be successfully treated.

      Type of study/level of evidence

      Therapeutic IV.

      Key words

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        • Bates D.G.
        Dynamic ultrasound findings of bilateral anterior tibialis muscle herniation in a pediatric patient.
        Pediatr Radiol. 2001; 31: 753-755
        • Roberts J.O.
        • Regan P.J.
        • Dickinson J.C.
        • Bailey B.N.
        Forearm muscle herniae and their treatment.
        J Hand Surg Br. 1989; 14: 319-321
        • Golshani S.D.
        • Lee C.
        • Sydorak R.
        Symptomatic forearm muscle hernia: repair by autologous fascia lata inlay.
        Ann Plast Surg. 1999; 43: 204-206
        • Kendi T.K.
        • Altinok D.
        • Erdal H.H.
        • Kara S.
        Imaging in the diagnosis of symptomatic forearm muscle herniation.
        Skeletal Radiol. 2003; 32: 364-366
        • Sanders B.S.
        • Bruce J.
        • Robertson J.
        Treatment of a symptomatic forearm muscle herniation with a mesh graft.
        Sports Health. 2011; 3: 179-181
        • Carrim Y.O.
        • Truter R.
        • Suleman F.
        • Andronikou S.
        Imaging diagnosis of muscle herniation of the forearm.
        SA Orthop J. 2014; 13: 39-42
        • Chan Y.H.
        Biostatistics 102: quantitative data--parametric & non-parametric tests.
        Singapore Med J. 2003; 44: 391-396
        • Chan Y.H.
        Biostatistics 103: qualitative data - tests of independence.
        Singapore Med J. 2003; 44: 498-503
        • Indiran V.
        Muscle hernia involving the extensor carpi ulnaris muscle.
        Indian J Plast Surg. 2016; 49: 427-429
        • Riordan C.
        • Hussain M.
        • McCann J.
        Forearm muscle hernia: a case report.
        Eur J Plast Surg. 2002; 25: 231-232
        • Khalid K.A.
        • Mah E.T.
        Treatment of a symptomatic forearm muscle herniation with a wrap-around fascia lata graft.
        J Hand Microsurg. 2009; 1: 54-59
        • Olch C.L.
        • Watson H.K.
        Symptomatic forearm fascial hernia.
        J Hand Surg Am. 1996; 21: 693-695