Prabhu Raghunath, Kumar Nawin, Shenoy Rajgopal
Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
BMJ Case Rep. 2013 Jun 12;2013:bcr2013010386. doi: 10.1136/bcr-2013-010386.
A 73-year-old man, who had undergone fracture fixation of humerus with LCP plating and bone grafting, presented again with a peri-implant fracture after 1 year. A repeat surgery was contemplated and replating was performed with tricortical bone graft harvested from the iliac crest. In the postoperative period the patient developed a tender swelling at the graft site with nausea and abdominal discomfort. It was managed conservatively thinking it to be a haematoma at the graft site. In the following 2 days his symptoms worsened. A CT abdomen showed the herniation of caecum from the bone graft donor site with obstruction. The patient was taken up for emergency surgical repair, the caecum was reduced and polypropylene mesh hernioplasty was performed. The patient recovered well without recurrence in the follow-up period. Iliac crest bone graft site hernia is not so uncommon and care has to be taken while harvesting.
一名73岁男性，曾接受过肱骨骨折切开复位锁定加压钢板（LCP）内固定及植骨手术，1年后因植入物周围骨折再次就诊。考虑再次手术，取自髂嵴的三层皮质骨移植骨进行再次钢板固定。术后患者移植部位出现压痛性肿胀，并伴有恶心和腹部不适。最初考虑为移植部位血肿，采取保守治疗。在接下来的2天里，他的症状加重。腹部CT显示盲肠从骨移植供区疝出并伴有梗阻。患者接受了急诊手术修复，将盲肠回纳并进行了聚丙烯网片疝修补术。患者恢复良好，随访期间无复发。髂嵴骨移植部位疝并不罕见，取骨时需谨慎。
