• B Del Frari, R Larndorfer, and H Piza-Katzer.
• Universitätsklinik für Plastische- und Wiederherstellungschirurgie, Medizinische Universität Innsbruck, Innsbruck, Osterreich. Barbara.Del-Frari@i-med.ac.at
• Unfallchirurg. 2008 Oct 1; 111 (10): 845849845-9.

AbstractPelvic fractures may accompany other injuries and can be life-threatening. In addition, the rectus abdominis muscles might also be torn. During fracture reduction, these muscles are fixed to their insertions. The goal should be reconstruction as close as possible to the original anatomic situation. Refixation of the vertical rectus muscles that have retreated cranially results in preventing development of lower abdominal wall hernia.A hernia in combination with a symphysis disruption has been reported very seldom in the available literature. We report here on a case of hernia that developed postoperatively after treatment of traumatic pubic symphysis rupture. Primary open reduction of the symphysis was carried out and the rectus abdominis muscles were refixed to the bones. An attempt was made to repair the incisional hernia that developed by tightening the fascia. Two and a half years after the accident, the patient developed a diastasis and an abdominal wall hernia, which were repaired by refixation of the rectus abdominis muscles to the bones with Mersilene bands. Results nine months after the reconstructive surgical intervention show a firm abdominal wall without recurrence.This case shows that even 2.5 years after an accident, the rectus abdomini muscles can be fixed with Mersilene bands to the bone and anatomic reconstruction of the abdominal wall can be carried out.

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