Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

Recommendations

Info

36. Sports Hernia with Adductor Tendonitis 455 Fig. 36.1. ( a ) T2-weighted axial oblique image of the pelvis demonstrating a cleft sign ( arrow ) just inferior to the pubic symphysis (PS); ( b ) T2- weighted sagittal image of the pelvis demonstrating hyperintense aponeurotic tears ( arrows ) of the rectus abdominis (RA) and adductor longus (AL) tendon insertions into the pubic bone (P). ated with a sports hernia is a labral tear , which is diagnosed with MRI [ 2 ]. Other diagnoses that are not part of the musculoskeletal system include appendicitis, urinary tract infections, testicular pain, varicoceles, round ligament entrapment, endometriosis, and ovarian cysts.
456 F.J. Brody and J. Harr Nonoperative Management Nonoperative management is initially provided for adductor tendonitis associated with groin pain and may include 3–9 months of rehabilitation with a physical therapist . These modalities may involve extensive stretching, deep tissue massage, electrical stimulation, and local injections. These injections employ mixtures of steroids with local anesthetics, and are injected directly into the pubic symphysis, pubic tubercle, or associated aponeuroses. Mixtures commonly include methylprednisolone mixed with 0.5 % bupivacaine , but other combinations of methylprednisolone, dexamethasone, lidocaine, and bupivacaine have been used as well. Overall, the majority of adductor tendon injuries should resolve with inactivity and nonoperative therapy. The goal of nonoperative therapy should restore a full range of motion, while maintaining muscle strength and preventing contracture of the adductor tendon or rectus sheath. Ultimately, the patient should regain strength, flexibility, and endurance quickly if nonoperative management is successful. However, chronic injuries located along the musculotendinous junction usually require operative intervention if athletic activities cannot be halted. Operative Management Our technique entails an inguinal incision along the skin crease located directly above the superficial ring. The dissection extends through Scarpa’s fascia to the external oblique aponeurosis. Tears in the external oblique aponeurosis are repaired with 4-0 nonabsorbable sutures since these tears may cause nerve impingements. The external oblique aponeurosis is then opened superiorly and inferiorly through the superficial ring. The spermatic cord is dissected at the level of the pubic tubercle, retracted laterally, and skeletonized to exclude a hernia sac. Once a hernia sac is excluded, a relaxing incision is made along the fascia of the conjoined tendon starting at the level of the deep ring , and extended inferiorly along the pubic bone (Fig. 36.2 ). The anterior rectus sheath is then released from the pubic bone by incising the aponeurosis approximately one cm superior to the pubic bone. This relaxing incision is then extended laterally until the transversalis fascia of the inguinal floor is encountered. The undersurface of the relaxing incision is undermined in an avascular plane. The sports hernia repair is performed by plicating the previously released fascia of the conjoined tendon to the iliopubic tract with a continuous 2-0 Prolene suture (Fig. 36.3 ). The first
Page 1:
Brian P. Jacob · David C. Chen Bru
Page 5 and 6:
The SAGES Manual of Groin Pain Bria
Page 7 and 8:
Foreword Inguinal hernia repair is
Page 9 and 10:
Contents Part I Primary Groin Pain
Page 11 and 12:
Contents ix 22 Management of Inguin
Page 13:
Contents xi 45 Value-Based Clinical
Page 16 and 17:
xiv Editors and Contributors Jeffre
Page 18 and 19:
xvi Editors and Contributors David
Page 20 and 21:
xviii Editors and Contributors Greg
Page 22 and 23:
xx Editors and Contributors David S
Page 24 and 25:
1. Introduction to Primary and Seco
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
10 I.A. Gawlas and W.J. Peacock Ili
Page 32 and 33:
12 I.A. Gawlas and W.J. Peacock Tra
Page 34 and 35:
14 I.A. Gawlas and W.J. Peacock Var
Page 36 and 37:
3. Complex Regional Pain Syndrome T
Page 38 and 39:
Page 40 and 41:
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
4. Chief Complaint of Groin Pain: H
Page 48 and 49:
4. Chief Complaint of Groin Pain…
Page 50 and 51:
Page 52 and 53:
Page 54 and 55:
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
42 C. Ma and A. Ramaswamy inguinal
Page 62 and 63:
44 C. Ma and A. Ramaswamy Categoriz
Page 64 and 65:
46 C. Ma and A. Ramaswamy with no s
Page 66 and 67:
48 C. Ma and A. Ramaswamy 26. Aasva
Page 68 and 69:
50 I.M. Daoud and K. Dunn Other per
Page 70 and 71:
52 I.M. Daoud and K. Dunn low herni
Page 72 and 73:
54 I.M. Daoud and K. Dunn In the po
Page 74 and 75:
56 I.M. Daoud and K. Dunn with a he
Page 76 and 77:
58 I.M. Daoud and K. Dunn 13. O’C
Page 78 and 79:
60 G.J. Mancini Occult Hernia Backg
Page 80 and 81:
62 G.J. Mancini Magnetic resonance
Page 82 and 83:
64 G.J. Mancini rocking motion can
Page 84 and 85:
66 G.J. Mancini Unique to the adduc
Page 86 and 87:
68 G.J. Mancini two nerve injuries
Page 88 and 89:
70 G.J. Mancini abdominis has a rep
Page 90 and 91:
72 G.J. Mancini 5. Light D, Ratnasi
Page 92 and 93:
74 J.C. Campbell and G.D. Paiement
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
9. Groin Pain Etiology: Spine and B
Page 122 and 123:
Page 124 and 125:
Page 126 and 127:
Page 128 and 129:
10. Groin Pain Etiology: Spermatic
Page 130 and 131:
Table 10.2. European Association of
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
138 M. Hibner and C. Coyne Piriform
Page 156 and 157:
140 M. Hibner and C. Coyne Fig. 11.
Page 158 and 159:
142 M. Hibner and C. Coyne Table 11
Page 160 and 161:
144 M. Hibner and C. Coyne present
Page 162 and 163:
146 M. Hibner and C. Coyne Table 11
Page 164 and 165:
148 M. Hibner and C. Coyne Once the
Page 166 and 167:
150 M. Hibner and C. Coyne 3. Hibne
Page 168 and 169:
12. Chronic Pelvic Pain in Women M.
Page 170 and 171:
12. Chronic Pelvic Pain in Women 15
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
174 J.M. Miller et al. Knowing the
Page 190 and 191:
176 J.M. Miller et al. Fig. 13.2. A
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
182 J.M. Miller et al. Fig. 13.9. C
Page 198 and 199:
184 J.M. Miller et al. Fig. 13.14.
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
192 J.M. Miller et al. Cardiac Cath
Page 208 and 209:
194 B.J. Dunkin Noxious peripheral
Page 210 and 211:
196 B.J. Dunkin Table 14.1. Summary
Page 212 and 213:
198 B.J. Dunkin Rectus abdominis Ex
Page 214 and 215:
200 B.J. Dunkin COX-1 COX-2 Celecpx
Page 216 and 217:
202 B.J. Dunkin Table 14.2. Common
Page 218 and 219:
204 B.J. Dunkin Possible Preoperati
Page 220 and 221:
206 B.J. Dunkin Postoperative Pain
Page 222 and 223:
208 B.J. Dunkin Summary Understandi
Page 224 and 225:
15. Chronic Groin Pain Following An
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
222 E.L. Felix not seem to alter th
Page 236 and 237:
224 E.L. Felix nerves from the surg
Page 238 and 239:
226 E.L. Felix Fig. 16.2. Lateral f
Page 240 and 241:
228 E.L. Felix It has been establis
Page 242 and 243:
230 E.L. Felix 18. Pollak R, Nyhus
Page 244 and 245:
17. The Orthopedic Perspective on G
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
246 J.F.M. Lange Jr. examination an
Page 258 and 259:
248 J.F.M. Lange Jr. and remedial s
Page 260 and 261:
250 J.F.M. Lange Jr. Best available
Page 262 and 263:
252 J.F.M. Lange Jr. Neuropathic pa
Page 264 and 265:
254 J.F.M. Lange Jr. This algorithm
Page 266 and 267:
19. Radiologic Evaluation for Posto
Page 268 and 269:
19 Radiologic Evaluation for Postop
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
268 A. Malhotra extended variant of
Page 278 and 279:
270 A. Malhotra steroid injections,
Page 280 and 281:
272 A. Malhotra located just below
Page 282 and 283:
274 A. Malhotra Nociceptive Acute N
Page 284 and 285:
276 A. Malhotra 20. Rozen D, Parvez
Page 286 and 287:
278 R. Álvarez intentionally or in
Page 288 and 289:
Fig. 21.1. Material: A ballpoint pe
Page 290 and 291:
Fig. 21.5. Dermatome mapping compat
Page 292 and 293:
Fig. 21.9. Dermatome mapping compat
Page 294 and 295:
286 R. Álvarez Subsequently, we mu
Page 296 and 297:
288 R. Álvarez G : Granuloma H : H
Page 298 and 299:
290 R. Álvarez Fig. 21.14. Same pa
Page 300 and 301:
292 R. Álvarez 6. Lermite E, Arnau
Page 302 and 303:
294 K.A. Seymour and J.S. Yoo Table
Page 304 and 305:
296 K.A. Seymour and J.S. Yoo repro
Page 306 and 307:
298 K.A. Seymour and J.S. Yoo Recur
Page 308 and 309:
23. Mesh Removal for Chronic Pain:
Page 310 and 311:
23. Mesh Removal for Chronic Pain
Page 312 and 313:
Page 314 and 315:
Page 316 and 317:
Page 318 and 319:
Page 320 and 321:
Page 322 and 323:
Page 324 and 325:
Page 326 and 327:
320 I.T. MacQueen et al. inguinodyn
Page 328 and 329:
322 I.T. MacQueen et al. Fig. 24.2.
Page 330 and 331:
324 I.T. MacQueen et al. Timing and
Page 332 and 333:
326 I.T. MacQueen et al. Fig. 24.4.
Page 334 and 335:
328 I.T. MacQueen et al. Posthernio
Page 336 and 337:
330 I.T. MacQueen et al. never be e
Page 338 and 339:
25. Laparoscopic Triple Neurectomy
Page 340 and 341:
Page 342 and 343:
Page 344 and 345:
Page 346 and 347:
Page 348 and 349:
26. Chronic Orchialgia: Workup and
Page 350 and 351:
Page 352 and 353:
Page 354 and 355:
Page 356 and 357:
Page 358 and 359:
Page 360 and 361:
Page 362 and 363:
Page 364 and 365:
Page 366 and 367:
Page 368 and 369:
27. The Role of Bioactive Prostheti
Page 370 and 371:
Page 372 and 373:
Page 374 and 375:
Page 376 and 377:
Page 378 and 379:
376 G. Campanelli et al. affecting
Page 380 and 381:
378 G. Campanelli et al. into the w
Page 382 and 383:
380 G. Campanelli et al. chronic gr
Page 384 and 385:
382 G. Campanelli et al. A prospect
Page 386 and 387:
384 G. Campanelli et al. open mesh
Page 388 and 389:
386 G. Campanelli et al. 38. Alfier
Page 390 and 391:
29. Prevention of Pain: Optimizing
Page 392 and 393:
Page 394 and 395:
Page 396 and 397:
Page 398 and 399:
30. Prophylactic Neurectomy Versus
Page 400 and 401:
30. Prophylactic Neurectomy Versus
Page 402 and 403: 30. Prophylactic Neurectomy Versus
Page 404 and 405: 30. Prophylactic Neurectomy Versus
Page 406 and 407: Table 31.1. Selective neurectomy wi
Page 408 and 409: 408 W.M.J. Reinpold and A.D. Schroe
Page 416 and 417: 32. Chronic Groin Pain: Mesh or No
Page 426 and 427: Part IV Case Reports and Patients
Page 428 and 429: 430 S. Towfigh were irregular and s
Page 430 and 431: 432 S. Towfigh in addressing her sy
Page 432 and 433: 434 S. Towfigh Conclusion We have y
Page 434 and 435: 436 K.W. Kercher Physical Examinati
Page 436 and 437: 438 K.W. Kercher Fig. 34.4. Left ad
Page 438 and 439: 440 K.W. Kercher Fig. 34.5. After d
Page 440 and 441: 442 K.W. Kercher the posterior wall
Page 442 and 443: 444 K.W. Kercher Table 34.2. Surgic
Page 444 and 445: 35. Chronic Post-inguinal Herniorrh
Page 446 and 447: 35 Chronic Post-inguinal Herniorrha
Page 448 and 449: 35 Chronic Post-inguinal Herniorrha
Page 450 and 451: 36. Sports Hernia with Adductor Ten
Page 460 and 461: 464 C.G. DuCoin and G.R. Jacobsen P
Page 462 and 463: 466 C.G. DuCoin and G.R. Jacobsen O
Page 464 and 465: 468 J.A. Blatnik and A.S. Prabhu a
Page 466 and 467: 470 J.A. Blatnik and A.S. Prabhu Fi
Page 468 and 469: 472 J.A. Blatnik and A.S. Prabhu ma
Page 470 and 471: 474 S. Towfigh Physical Exam The pa
Page 472 and 473: 476 S. Towfigh The patient’s loca
Page 474 and 475: 478 S. Towfigh Fig. 39.2. Diagram o
Page 476 and 477: 480 S. Towfigh periphery. He is 2+
Page 478 and 479: 482 S. Towfigh References 1. Matthi
Page 480 and 481: 484 N.A. Al-Enazi and B.P. Jacob
Page 482 and 483: 486 N.A. Al-Enazi and B.P. Jacob Fi
Page 484 and 485: 488 N.A. Al-Enazi and B.P. Jacob pu
Page 486 and 487: 42. Patient with Chronic Pelvic Pai
Page 488 and 489: 42. Patient with Chronic Pelvic Pai
Page 490 and 491: 43. Thoracolumbar Syndrome James A.
Page 492 and 493: 43. Thoracolumbar Syndrome 497 The
Page 494 and 495: 43. Thoracolumbar Syndrome 499 Groi
Page 496 and 497: 44. Patient with Referred Hip Pain
Page 498 and 499: 44. Patient with Referred Hip Pain
Page 500 and 501: 45. Value-Based Clinical Quality Im
Page 502 and 503:
45. Value-Based Clinical Quality Im
Page 504 and 505:
Page 506 and 507:
Page 508 and 509:
Page 510 and 511:
46. Patient Care Manager Perspectiv
Page 512 and 513:
Page 514 and 515:
Page 516 and 517:
Page 518 and 519:
47. Workers’ Compensation: An Occ
Page 520 and 521:
Page 522 and 523:
Page 524 and 525:
Page 526 and 527:
532 Index Athletic pubalgia (cont.)
Page 528 and 529:
534 Index Chronic post-herniorrhaph
Page 530 and 531:
536 Index Groin pain (cont.) magnet
Page 532 and 533:
538 Index Ilioinguinal nerve (IIN)
Page 534 and 535:
540 Index Local anesthetics (cont.)
Page 536 and 537:
542 Index Peripheral nerve entrapme
Page 538 and 539:
544 Index S Sacroiliac (SI) joint d
Page 540:
546 Index Transperineal pudendal ne
show all

Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?