Rajeev Akash, Vinod Ashwin, John George M, Jacob Pradeep, Ramachandran Riju, Marwaha Vishal
General Surgery, Amrita Institute of Medical Sciences and Hospital, Kochi, IND.
Rheumatology, Amrita Institute of Medical Sciences and Hospital, Kochi, IND.
Cureus. 2022 Jan 15;14(1):e21269. doi: 10.7759/cureus.21269. eCollection 2022 Jan.
Introduction One of the most prevalent disorders treated by general surgeons is inguinal hernias. Many of the etiological factors that lead to hernia development are unknown. This study looked at the role of pelvic bone anatomy in the development of inguinal hernia. The pubic tubercle's location (as measured by the Radoievitch angle) and its relationship to the formation of inguinal hernia, as well as its function in the pathophysiology of various forms of inguinal hernia, were investigated. Materials and methods From October 2019 to June 2021, a prospective case-control study with 70 individuals over the age of 18 years in each arm was conducted in the Department of General Surgery at our tertiary care institution. Plain digital X-ray radiography of the pelvis, including bilateral hips, was taken in the anteroposterior (AP) view with the patient in the supine position, and the Radoievitch angle and Ami line were measured using suitable measuring instruments. The required information for patients in both groups was tallied and examined in a data sheet. Results Between the case and control groups, there was a statistically significant difference in the mean Radoievitch angles and the mean length of the Ami line (42.46 +/-2.442 degrees vs 40.91 +/-2.547 degrees; p<0.05); (8.54+/-1.059 cm vs 7.27+/-1.034 cm; p<0.05). There was a statistically significant increase in the Radoievitch angle of patients with bilateral hernias compared to unilateral hernias (p-value <0.01), as well as indirect hernias compared to other forms of hernias (p-value <0.05). Conclusion The probability of having an inguinal hernia was higher when the Fruchaud region was increased, as indicated by a larger Radoievitch angle or a longer Ami line. A low-lying pubic tubercle increased the likelihood of bilateral and indirect inguinal hernias. Pelvimetry is an easy test that should be considered on a routine basis and can be applied accurately in all patients. Surgeons can employ pelvimetry to identify patients who are more likely to benefit from non-mesh repairs.
引言 普通外科医生治疗的最常见疾病之一是腹股沟疝。许多导致疝形成的病因尚不清楚。本研究探讨了骨盆骨解剖结构在腹股沟疝形成中的作用。研究了耻骨结节的位置（通过拉多耶维奇角测量）及其与腹股沟疝形成的关系，以及其在各种类型腹股沟疝病理生理学中的作用。
材料和方法 2019年10月至2021年6月，在我们的三级医疗机构普通外科进行了一项前瞻性病例对照研究，每组有70名18岁以上的个体。患者仰卧位，拍摄包括双侧髋关节的骨盆前后位普通数字X线片，使用合适的测量工具测量拉多耶维奇角和阿米线。将两组患者的所需信息记录在数据表中并进行检查。
结果 病例组和对照组之间，平均拉多耶维奇角和阿米线的平均长度存在统计学显著差异（42.46±2.442度 vs 40.91±2.547度；p<0.05）；（8.54±1.059厘米 vs 7.27±1.034厘米；p<0.05）。与单侧疝相比，双侧疝患者的拉多耶维奇角有统计学显著增加（p值<0.01），与其他类型的疝相比，间接疝患者的拉多耶维奇角也有统计学显著增加（p值<0.05）。
结论 当弗罗绍德区域增大时，即拉多耶维奇角更大或阿米线更长时，发生腹股沟疝的可能性更高。低位耻骨结节增加了双侧和间接腹股沟疝的可能性。骨盆测量是一项简单的检查，应常规考虑并可准确应用于所有患者。外科医生可以利用骨盆测量来识别更可能从无网片修补中受益的患者。
