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外伤性肌疝在临床上并不少见,但双小腿深筋膜先天性发育不良并多发性肌疝在临床上较罕见,作者收治1例报告如下: 患者男性,20岁,战土,因剧烈活动后双小腿多发性包块、疼痛2年入院。患者2年前入伍参加军训约1个月左右双小腿出现2～3处包块,初如花生米大小,有胀疼感,休息后可自行消失,随着时间推移,训练强度的增大,包块逐渐增大,数量增多,疼痛症状加重,此后只要活动量稍人,包块即复发,影响训练和日常生活而住院治疗。查体:慢跑20分钟后见右小腿6个、左小腿5个0.5cm×0.5cm～4cm×5cm大小不等散在的包块,质软,压之包块内陷。其周边为椭圆形条索状缘,压痛。诊断为:双小腿深筋膜先天性发育不良并多发性肌疝,拟行双小腿肌疝修补术。术前让患者活动后在包块体表用美蓝做标记,切开见标记处深筋膜呈大小不等的破损,周围未破损筋膜也较正常筋膜组织薄弱,有些部位的深筋膜只有透明的薄薄一层,小的破损用丝线拉拢缝合,大的缺损取大腿阔筋膜修补。术后予以弹性绷带包扎,4周下地: 三个月后随访小腿活动正常,原肌疝消失、无复发。 深筋膜由致密结缔组织构成,主要包裹在肌肉外,可随肌的分层而分层,既能保护肌免受磨擦,还可通过分隔肌群
Traumatic hernia is not uncommon in clinical practice, but the double leg deep fascia congenital hypoplasia and multiple myx hernia is clinically rare, the authors admitted to a report as follows: The patient male, 20 years old, battlefield, due to severe After the event double varicose mass, pain 2 years admitted. Patient 2 years ago to join the military training about 1 month or so there are 2 to 3 double calf mass, beginning with the size of peanuts, swelling pain, after rest can disappear on their own, as time goes by, training intensity increases, Mass gradually increased, the number increased, the pain worsened, since as long as the activity of a few people, the mass is recurrence, affecting training and daily life and hospitalization. Examination: jogging 20 minutes after see the right leg 6, left leg 5 0.5cm × 0.5cm ~ 4cm × 5cm scattered scattered mass, soft, pressure of the mass invagination. Its periphery is oval-shaped cord-like edge, tenderness. Diagnosis: double leg deep fascia congenital dysplasia and multiple myxeiasis, proposed double calf muscle hernia repair. Preoperative patient activities in the mass of the body surface with methylene blue mark, incision marked deep fascia showed the size of the damaged around the non-damaged fascia than the normal fascia is weak, some parts of the deep tendons The film is only a thin layer of transparent, small damage with silk suture closure, a large defect to take laparoscopic fascia repair. After surgery to be elastic bandage, 4 weeks to: follow-up three months after the normal leg movement, the original hernia disappeared, no recurrence. Deep fascia by the dense connective tissue, mainly wrapped in the muscle, can be layered with the muscle stratification, both to protect the muscle from friction, but also through the separation of muscles