Roham Ali, Gardner Preston, Heller Joseph, Gerken Jeffrey, Lumley Christopher
Dept of Plastic Surgery, Beaumont Health System, Farmington Hills, MI, USA.
Dept of Plastic Surgery, Beaumont Health System, Farmington Hills, MI, USA.
Int J Surg Case Rep. 2018;49:153-157. doi: 10.1016/j.ijscr.2018.07.002. Epub 2018 Jul 7.
Traumatic lumbar hernias are not common hernias that are encountered by general or plastic surgery teams, however it is important to understand the anatomy of the hernia in order to be able to correct the flank defect. In our patient, the oblique muscles were sheared off the iliac crest periosteum, however the attachments to the ribs and spine were maintained. We were able to successfully place a pre-peritoneal polypropylene mesh which was secured to the musculature, and re-approximate the oblique muscles to the iliac crest using Mitek QUICKANCHOR sutures. Our case study has been reported in line with the SCARE criteria ([8] Agha et al., 2016).
The subject in our case was a 47-year-old gentleman who was involved in a motor vehicle accident, and sustained a traumatic lumbar hernia due to the 3-point seatbelt he was wearing. He was transported via ambulance to our trauma center.
Understanding the anatomy and mechanism of injury is the key to reconstructing traumatic lumber hernias. Although not required, mesh reinforcement has significantly reduced the recurrence of all hernias. This is the simplest and most effective way, in our opinion, to return the flank muscles to their native position while providing mesh reinforcement.
创伤性腰椎疝并非普通外科或整形外科团队常见的疝，但了解疝的解剖结构对于修复侧腹缺损至关重要。在我们的患者中，斜肌从髂嵴骨膜上撕脱，但与肋骨和脊柱的附着仍保持。我们成功放置了一块腹膜前聚丙烯补片，将其固定于肌肉组织，并使用Mitek快速锚定缝线将斜肌重新贴合至髂嵴。我们的病例报告已按照SCARE标准进行报道（[8] Agha等人，2016年）。
我们病例中的患者是一名47岁男性，他遭遇了一场机动车事故，因佩戴三点式安全带而导致创伤性腰椎疝。他通过救护车被送往我们的创伤中心。
了解损伤的解剖结构和机制是修复创伤性腰椎疝的关键。虽然并非必需，但补片加固显著降低了所有疝的复发率。在我们看来，这是将侧腹肌肉恢复至原位同时提供补片加固的最简单且最有效的方法。
