Harr J N, Brody F
Department of Surgery, The George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC, 20037, USA.
Hernia. 2017 Feb;21(1):139-147. doi: 10.1007/s10029-016-1520-8. Epub 2016 Aug 6.
Sports hernias, or athletic pubalgia, is common in athletes, and primarily involves injury to the fascia, muscles, and tendons of the inguinal region near their insertion onto the pubic bone. However, management varies widely, and rectus and adductor tenotomies have not been adequately described. The purpose of this manuscript is to demonstrate a suture repair and a rectus and adductor longus tenotomy technique for sports hernias.
After magnetic-resonance-imaging confirmation of sports hernias with rectus and adductor tendonitis, 22 patients underwent a suture herniorrhaphy with adductor tenotomy. The procedure is performed through a 4-cm incision, and a fascial release of the rectus abdominis and adductor tenotomy is performed to relieve the opposing vector forces on the pubic bone.
All 22 patients returned to their respective sports and regained their ability to perform at a high level, including professional status. No further surgery was required.
In athletes with MRI confirmation of rectus and adductor longus injuries, tenotomies along with a herniorraphy may improve outcomes. A suture repair to reinforce the inguinal floor prevents mesh-related complications, especially in young athletes.
运动性疝，即运动员耻骨痛，在运动员中很常见，主要涉及腹股沟区筋膜、肌肉和肌腱在耻骨附着处的损伤。然而，治疗方法差异很大，腹直肌和内收肌切断术尚未得到充分描述。本文的目的是展示一种运动性疝的缝合修复以及腹直肌和内收肌长肌切断术技术。
在磁共振成像确认患有运动性疝并伴有腹直肌和内收肌腱炎后，22例患者接受了内收肌切断术的缝合疝修补术。该手术通过一个4厘米的切口进行，对腹直肌进行筋膜松解和内收肌切断，以减轻耻骨上相反的矢量力。
所有22例患者均恢复了各自的运动项目，并重新获得了高水平的运动能力，包括职业水平。无需进一步手术。
对于经磁共振成像确认腹直肌和内收肌长肌损伤的运动员，切断术联合疝修补术可能会改善治疗效果。缝合修复以加强腹股沟底部可预防与补片相关的并发症，尤其是在年轻运动员中。
