运动员腹股沟-诊断方法和最小修复技术治疗：单中心非对照临床回顾。
Sportsmen's Groin-Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review.
机构信息
Hernia Center Dr Muschaweck, Munich, Germany.
出版信息
Sports Health. 2010 May;2(3):216-21. doi: 10.1177/1941738110367623.
CONTEXT
Sportsmen's groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms.
METHODS
The authors developed an innovative open suture repair-the Minimal Repair technique-to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures.
RESULTS
THE FOLLOWING ADVANTAGES OF THE MINIMAL REPAIR TECHNIQUE WERE FOUND: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median).
CONCLUSION
The Minimal Repair technique is an effective and safe way to treat sportsmen's groin.
背景
运动员腹股沟，也称为运动疝和吉尔莫腹股沟，是运动员最常见的运动损伤之一，可能使运动员生涯面临风险。它表现为急性或慢性腹股沟疼痛，活动时加剧。到目前为止，对于发病机制、诊断标准或治疗方法还没有达成共识。人们已经尝试过各种方法来解释腹股沟疼痛的原因。假设腹股沟管后壁有局限性薄弱，导致局部膨出，从而压迫生殖股神经的生殖支，被认为是引起症状的原因。
方法
作者开发了一种创新的开放式缝合修复技术——最小修复技术，以满足职业运动员的需求。通过这种技术，腹股沟管后壁的局限性薄弱部位用弹性缝线修复；消除对神经的压迫，消除疼痛的原因。与常见的开放式缝合修复不同，后壁的缺陷没有扩大，缝线几乎没有张力，患者可以在更短的时间内恢复全面训练和运动活动。将采用最小修复技术的患者的手术结果与常用的手术方法进行了比较。
结果
发现最小修复技术具有以下优点：无需插入假体网，无需全身麻醉，创伤更小，严重并发症的风险更低，恢复更快。2009 年，一项前瞻性队列研究显示，129 例患者中有 129 例在 7 天内恢复训练，平均 14 天内完全缓解疼痛。职业运动员（67%）在 14 天内（中位数）恢复到完全活动。
结论
最小修复技术是治疗运动员腹股沟的有效且安全的方法。
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