Calcific Myonecrosis: Case Report of a Rare Clinical Presentation and Literature Review.

Introduction and importance: Calcific myonecrosis is a rare entity characterized by coagulative and liquefactive necrosis with calcifications of the entire muscle mass of the involved compartment secondary to post-traumatic compartment syndrome. There is limited literature on the rare disease with technical difficulties and pitfalls of operative procedures in these patients.

Presentation of case: A 52-year-old male presented with complaints of swelling over his right leg with discharging sinus over the past 2 years following a surgical intervention. He was diagnosed as a case of calcific myonecrosis based on history and clinico-radio-histological correlation and was managed successfully with en bloc excision with vacuum-assisted closure (VAC) of wound.

Clinical discussion: A rare musculoskeletal condition is characterized by muscle necrosis and extensive calcification within a limb compartment, typically following post-traumatic compartment syndrome involving muscle and neurovascular structures. Diagnosis relies heavily on radiological findings, such as calcifications and adjacent bone erosions, while histopathology is crucial to exclude malignancy. A high index of clinical suspicion is essential for timely identification.

Conclusion: Calcific myonecrosis requires a multi-factorial approach to reach to a diagnosis, with ruling out the differentials and proper preoperative plan are the key to success. If un-infected, it is a "Touch me not disease"; however, through debridement or en-mass excision of compartment with VAC therapy should be considered for infected cases.