The subject of myocele, or true muscle hernia, is dealt with very briefly in standard textbooks and has received scant consideration in the literature, a review of the latter disclosing less than 200 cases. Original reference to this lesion as a distinct entity was made in 1839 by the eminent French surgeon, Dupuytren,1 who recorded a muscular hernia which had been mistaken for a varicose vein. Further study resulted in the differentiation of myocele from muscle rupture, or pseudohernia, the first consisting of a protrusion of intact muscle through a defect in its sheath, in contradistinction to the second, a forceful separation of the muscle fibers either at insertion or, more usually, at the origin.
Myoceles occur predominantly in the lower extremity, and are most often found beneath knee level. They may be unilateral or bilateral, single or multiple. Kitchin and Richmond2 reported a patient who had 4