scholarly journals Side Strain and Impact Injuries at the Iliac Crest Attachment of Lateral Abdominal Wall Musculature in Cricketers: An Uncommon Injury Pattern

2021 ◽  
Author(s):  
Chinmay P. Mehta ◽  
Aditya Daftary ◽  
Malini Lawande
Keyword(s):  
Abdominal Wall ◽  
Iliac Crest ◽  
Injury Pattern ◽  
Transversus Abdominis ◽  
Muscle Injuries ◽  
Lateral Abdominal Wall ◽  
Abdominal Wall Muscle ◽  
External Oblique ◽  
Degrees Of Severity ◽  
Impact Injuries

AbstractSide strains refer to injuries of the internal/external oblique or the transversus abdominis, commonly at their attachment to the lower four ribs and rarely at their pelvic attachments. Injuries at the rib attachments are well-described while literature on iliac crest attachment injuries is sparse. We report four cricketers who had side strain and direct impact injuries with varying degrees of severity at the iliac crest attachment. The purpose of this article is to describe the anatomy, possible mechanism of injury, and imaging findings in the lateral abdominal wall muscle injuries at the iliac crest, which have not been described previously.

scholarly journals O50 ALTERATIONS IN THE ABDOMINAL WALL MUSCULATURE AFTER ENDOSCOPIC ANTERIOR AND OPEN POSTERIOR COMPONENT SEPARATION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Erling Oma ◽  
Jan Kim Christensen ◽  
Jorge Daes ◽  
Lars Nannestad Jorgensen
Keyword(s):  
Abdominal Wall ◽  
Case Series ◽  
Muscle Thickness ◽  
Component Separation ◽  
Fascial Closure ◽  
Lateral Abdominal Wall ◽  
Transverse Abdominis ◽  
Abdominal Wall Muscle ◽  
Anterior Component Separation

Abstract Aim Effects of component separation (CS) on abdominal wall musculature have only been investigated in smaller case series. The study aimed to compare abdominal wall alterations following endoscopic anterior component separation (EACS) or transverse abdominis release (TAR). Material and Methods Computed tomography scans were evaluated in patients who underwent open ventral hernia repair with TAR or EACS. Lateral abdominal wall muscle thickness and displacement were compared with preoperative images after bilateral CS and the undivided side postoperatively after unilateral CS. Results In total, 105 patients were included. The mean defect width was 12.2 cm. Fifty-five (52%) and 15 (14%) underwent bilateral and unilateral EACS, respectively. Five (5%) and 14 (13%) underwent bilateral and unilateral TAR, respectively. Sixteen (15%) underwent unilateral EACS and contralateral TAR. Complete fascial closure was achieved in 103 (98%) patients. The external oblique and transverse abdominis muscles were significantly laterally displaced with a mean of 2.74 cm (95% CI 2.29-3.19 cm) and 0.82 cm (0.07-1.57 cm) after EACS and TAR, respectively. The combined thickness of the lateral muscles was significantly decreased after EACS (mean decrease 10.5% [5.8-15.6%]) and insignificantly decreased after TAR (mean decrease 2.6% [-4.8-9.5%]), mean reduction difference EACS versus TAR 0.22 cm (-0.01-0.46 cm). One (1%) patient developed an iatrogenic linea semilunaris hernia after EACS. The recurrence rate was 19% after mean 1.7 years follow-up. Conclusions The divided muscle was significantly more laterally displaced after EACS compared with TAR. The thickness of the lateral muscles was slightly decreased after EACS and unchanged after TAR.

Concomitant Anterior and Posterior Component Separations: Absolutely Contraindicated?

2020 ◽  
pp. 155335062091419
Author(s):  
Jorge Daes ◽  
Joshua S. Winder ◽  
Eric M. Pauli
Keyword(s):  
Abdominal Wall ◽  
Lateral Displacement ◽  
Abdominal Wall Reconstruction ◽  
Component Separation ◽  
Transversus Abdominis ◽  
Lateral Abdominal Wall ◽  
Computed Tomography Images ◽  
Fresh Cadaver ◽  
Semilunar Line ◽  
Internal Oblique

Many experts in abdominal wall reconstruction believe that the combination of simultaneous ipsilateral anterior component separation (ACS) and posterior component separation (PCS) is contraindicated. We performed ipsilateral endoscopic ACS and either endoscopic or open PCS-transversus abdominis release (TAR) in 5 fresh cadaver models. The full length of the semilunar line and the lateral abdominal wall remained well reinforced by 2 complete layers, comprising the internal oblique (IO) and TA muscles and their investing fasciae. Myofascial releases occurred 4 cm (median) apart. Additionally, we reviewed computed tomography images at 1 month and 1 year after PCS-TAR in 17 patients (30 PCS-TARs). Lateral displacement of the TA relative to the rectus abdominis (RA) was significant only at the superior mesenteric artery level, where it was <1 cm (median). Muscle mass changed minimally over time. Several studies showed that abdominal wall reconstruction after PCS-TAR results in compensatory muscular hypertrophy of the RA, external oblique (EO), and IO muscles and provides better quality of life and improved core physiology. These changes did not occur when the midline was not restored. Theoretically, endoscopic ACS-EO may be added to PCS-TAR to avoid partially bridged mesh repair in patients in whom complete midline restoration is impossible via PCS-TAR alone. Nevertheless, we advise most surgeons to perform a small-bridged repair instead of risking increased morbidity by attempting a highly complicated procedure.

scholarly journals Surface electromyography comparison of the abdominal hypopressive gymnastics against the prone bridge exercise

2019 ◽  
Vol 12 (3) ◽  
pp. 243-246
Author(s):  
Gonzalo Alfonso Quiroz Sandoval ◽  
Nathalie Tabilo ◽  
Cristóbal Bahamondes ◽  
Pilar Bralic
Keyword(s):  
Abdominal Wall ◽  
Muscle Activity ◽  
Surface Electromyography ◽  
Healthy Subjects ◽  
Muscle Activation ◽  
Transversus Abdominis ◽  
Abdominal Pressure ◽  
Abdominal Muscles ◽  
External Oblique ◽  
Internal Oblique

Objectives: Abdominal hypopressive gymnastics (AHG) is a little-researched method designed to train the muscles of the abdominal wall and pelvic floor under low stress. This study’s objective is to compare levels of muscle activation in AHG against prone bridge by surface electromyography (sEMG) of the abdominal wall muscles. Methods: Twenty healthy subjects were enrolled to measure the muscle activity of the rectus abdominis (RA), transversus abdominis/internal oblique (Tra/IO), and external oblique (EO) during three exercises: prone bridge (PB), orthostatic hypopressive (OH), and hypopressive bridge (HB). Root mean square values normalized to the PB (%PB) as a baseline were used to compare the PB against OH and HB. Results: The median PB ratio (%PB) for the Tra/IO showed –10.31% and +59.7% activation during OH and the HB, respectively, whereas the RA showed –77.8% and +19.3% and the EO –39.8% and +9.8%. Significant differences were found for all muscles except the Tra/IO during the OH. Conclusion: This study’s results suggest that hypopressive exercises facilitate the activation of the Tra/IO similar to bridge exercises while simultaneously reducing RA and EO activity. This suggests that hypopressive training is a valid alternative for activating the abdominal muscles, isolating the Tra/IO at low intra-abdominal pressure.

scholarly journals Side-to-side asymmetry in absolute and relative muscle thickness of the lateral abdominal wall in cricket pace bowlers

2013 ◽  
Vol 25 (3) ◽  
pp. 81
Author(s):  
B Olivier ◽  
AV Stewart ◽  
W Mckinon
Keyword(s):  
Abdominal Wall ◽  
Muscle Thickness ◽  
Protective Role ◽  
Abdominal Muscle ◽  
Transversus Abdominis ◽  
Abdominal Musculature ◽  
Lateral Abdominal Wall ◽  
The Right ◽  
Straight Leg Raise ◽  
Lower Back Injury

Background. The abdominal musculature plays a protective role against lower-back injury. Knowledge of the asymmetry in abdominal wall thickness in healthy, injury-free cricket pace bowlers may provide a useful platform against which pathology could be assessed and the effects of training could be evaluated.Objective. To compare side-to-side differences in absolute muscle thickness and activity of the abdominal musculature and to compare these measurements at the start, with those at the end of a cricket season among a group of amateur pace bowlers.Methods. This was a controlled longitudinal prospective study. Rehabilitative ultrasound imaging was used to assess abdominal muscle thickness in 26 right-handed, injury-free cricket pace bowlers at the start and at the end of a cricket season. Thickness measurements were done at rest, during an abdominal drawing-in manoeuvre (ADIM) and the active straight-leg raise (ASLR) on the left (-L) and right (-R).Results. The absolute thickness of the non-dominant obliquus abdominis internus (OI) was higher than that of the dominant OI at the start (p=0.001; ES=0.87) as well as at the end of the cricket season (p=0.001; ES 1.09). At the start of the season, the percentage change during the ADIM, thus muscle activity, was higher for the non-dominant OI than for the dominant OI (p=0.02; ES=0.51). Absolute thickness of the dominant obliquus abdominis externus (OE) at rest was significantly higher at the end of the season compared with the start of the season (p=0.0001; ES=0.85). During ASLR-R, the activity of the left transversus abdominis (TA) was significantly higher than that of the right TA during ASLR-L (p=0.03) when measured at the end of the season.Conclusion. This study highlights the possible muscle adaptations in absolute muscle thickness and activity as a consequence of the asymmetrical bowling action.

scholarly journals Combined caudal retrocostal and lateral ultrasound-guided approach for transversus abdominis plane injection: A descriptive pilot study in pig cadavers

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248131
Author(s):  
Ivana Calice ◽  
Silvio Kau ◽  
Christian Knecht ◽  
Pablo E. Otero ◽  
M. Paula Larenza Menzies
Keyword(s):  
Abdominal Wall ◽  
Iliac Crest ◽  
Lateral Approach ◽  
Transversus Abdominis ◽  
Anesthetic Technique ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Injection Point ◽  
Costal Arch ◽  
Regional Anesthetic

Transversus abdominis plane (TAP) block is a regional anesthetic technique used to desensitize the abdominal wall in several species. This study aimed to describe the anatomical characteristics of the abdominal wall and to identify a feasible approach for an US-guided TAP injection that would result in adequate staining of the relevant nerves in the abdominal wall in pig cadavers. Fresh cadavers from five Landrace pigs (age, 12 weeks; body weight, 35.5 ± 1.6 kg) were used. One pig (n = 1) was anatomically dissected, and four pigs (n = 4; i.e., 8 hemiabdomens) were used for TAP injections and evaluation of dye spread. The volume of 0.3 mL/kg/injection point of methylene blue was injected bilaterally. In the caudal retrocostal approach, the injection was performed ventral to the most caudal part of the costal arch. In the lateral approach, the injection was performed between the last rib and iliac crest. A needle was inserted in plane for the caudal retrocostal and the lateral approach caudocranially and craniocaudally, respectively. Successful staining was defined as presence of dye on the nerve for a length of >1 cm in its entire circumference. The TAP was found between different muscle layers in the described anatomical regions. In the caudal retrocostal approach the TAP was found between the external abdominal oblique and transversus abdominis muscle bellies. In the lateral approach the TAP was found between the internal abdominal oblique and transversus abdominis muscles. The approach combining lateral and caudal retrocostal injections at the studied volume stained a median of 5 (3–6) target nerves from the fourth-last thoracic nerve to L2 (six nerves). Combined caudal retrocostal and lateral TAP injections of 0.3 mL/kg/injection point, resulted in staining of target nerve branches which supply the periumbilical and caudal abdominal wall in pig cadavers.

scholarly journals Side-to-side asymmetry in absolute and relative muscle thickness of the lateral abdominal wall in cricket pace bowlers

2013 ◽  
Vol 25 (3) ◽  
pp. 81 ◽  
Author(s):  
B Olivier ◽  
AV Stewart ◽  
W Mckinon
Keyword(s):  
Abdominal Wall ◽  
Muscle Thickness ◽  
Protective Role ◽  
Abdominal Muscle ◽  
Transversus Abdominis ◽  
Abdominal Musculature ◽  
Lateral Abdominal Wall ◽  
The Right ◽  
Straight Leg Raise ◽  
Lower Back Injury

Background. The abdominal musculature plays a protective role against lower-back injury. Knowledge of the asymmetry in abdominal wall thickness in healthy, injury-free cricket pace bowlers may provide a useful platform against which pathology could be assessed and the effects of training could be evaluated.Objective. To compare side-to-side differences in absolute muscle thickness and activity of the abdominal musculature and to compare these measurements at the start, with those at the end of a cricket season among a group of amateur pace bowlers.Methods. This was a controlled longitudinal prospective study. Rehabilitative ultrasound imaging was used to assess abdominal muscle thickness in 26 right-handed, injury-free cricket pace bowlers at the start and at the end of a cricket season. Thickness measurements were done at rest, during an abdominal drawing-in manoeuvre (ADIM) and the active straight-leg raise (ASLR) on the left (-L) and right (-R).Results. The absolute thickness of the non-dominant obliquus abdominis internus (OI) was higher than that of the dominant OI at the start (p=0.001; ES=0.87) as well as at the end of the cricket season (p=0.001; ES 1.09). At the start of the season, the percentage change during the ADIM, thus muscle activity, was higher for the non-dominant OI than for the dominant OI (p=0.02; ES=0.51). Absolute thickness of the dominant obliquus abdominis externus (OE) at rest was significantly higher at the end of the season compared with the start of the season (p=0.0001; ES=0.85). During ASLR-R, the activity of the left transversus abdominis (TA) was significantly higher than that of the right TA during ASLR-L (p=0.03) when measured at the end of the season.Conclusion. This study highlights the possible muscle adaptations in absolute muscle thickness and activity as a consequence of the asymmetrical bowling action.

scholarly journals Lateral Abdominal Wall Reconstruction

2018 ◽  
Vol 32 (03) ◽  
pp. 141-146 ◽  
Author(s):  
Sahil Kapur ◽  
Charles Butler
Keyword(s):  
Abdominal Wall ◽  
Iliac Crest ◽  
Surgical Repair ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Wall Defects ◽  
Costal Margin ◽  
Challenging Problem ◽  
Muscle Denervation ◽  
Careful Planning ◽  
Lateral Abdominal Wall

AbstractLateral abdominal wall defects, while rare, present a more challenging problem than commonly encountered ventral defects due to the complexity of the anatomy, physiologic forces, and impact of muscle denervation. The lateral abdominal wall encompasses a large surface area ranging from the costal margin superiorly to the iliac crest inferiorly and from the linea semilunaris anteriorly to the paraspinous musculature posteriorly. The ratio of muscle to fascia/aponeurosis is much higher, which makes repair through muscle tissue versus fascia less secure. Furthermore, these defects are subject to asymmetric forces caused by the independent contraction of anterior and posterior muscle units, which lead to unbalanced strain and hernia progression. These features necessitate the use of wide underlay mesh load bearing repairs supported by the static pillars of the abdominal wall. Management can be further complicated when defects extend beyond the defined boundaries, requiring surgical repair to be adapted based on the border structures involved. Primary fascial coaptation may not be as easily accomplished, and therefore careful planning is important to ensure stable coverage of exposed mesh.

scholarly journals Laparoscopic repair of interparietal abdominal wall hernias

2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
Christopher L Kalmar ◽  
Curtis E Bower
Keyword(s):  
Computed Tomography ◽  
Abdominal Wall ◽  
Laparoscopic Repair ◽  
Transversus Abdominis ◽  
Laparoscopic Technique ◽  
Limited Experience ◽  
Computed Tomography Scans ◽  
External Oblique ◽  
Internal Oblique

Abstract Interparietal hernias are rare abdominal defects where intraabdominal contents protrude between layers of the abdominal wall. There is limited experience using laparoscopic technique for repairing substantially large interparietal hernias. Computed tomography scans of both cases herein demonstrated intact external oblique, but the internal oblique and transversus abdominis were widely detached from the linea semilunaris. Our experience demonstrates the largest interparietal hernias treated entirely with laparoscopic repair, which successfully resolved symptoms and abdominal wall irregularity, as well as allowed discharge on the first postoperative day without complication.

scholarly journals Hypoplasia of abdominal wall muscles following massive fetal persistent chylous ascites without anemia

2021 ◽  
Vol 2021 (6) ◽  
Author(s):  
Tetsu Yamaguchi ◽  
Shunsuke Tamaru ◽  
Natsuko Takano ◽  
Kazuko Sato ◽  
Hayato Sakurai ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Genetic Variants ◽  
Genetic Test ◽  
Genetic Disorders ◽  
Chylous Ascites ◽  
Prune Belly Syndrome ◽  
Fetal Hydrops ◽  
Sitting Posture ◽  
Lateral Abdominal Wall ◽  
Abdominal Wall Muscle

ABSTRACT Abdominal wall hypoplasia is a widely known clinical finding of genetic disorders such as the prune belly syndrome. On the other hand, there are few cases of abdominal wall muscle hypoplasia associated with fetal ascites due to fetal hydrops caused by fetal anemia have been reported. We report a case of fetal chylous ascites without anemia, resulting in abdominal wall muscle hypoplasia and flabby skin. At 17 weeks of gestation, fetal ascites was first detected and deteriorated without anemia. At 28, 33 and 36 weeks of gestation, paracentesis was performed three times because of cardiovascular impairment, confirming chylous ascites. After birth, the baby exhibited a flabby skin and lateral abdominal wall hypoplasia, resulting in difficulties in maintaining a sitting posture at 10 months of age. The genetic test using the TruSight One Sequencing Panels found no genetic variants. This case suggests that abdominal wall hypoplasia could be associated with fetal ascites without anemia.

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