ORTHOPEDIC LONG-TERM ASPECTS OF BLADDER EXTROPHY

This study evaluates long term orthopaedic aspects of children with bl adder extrophy who were operated on using different techniques and at different ages, Data were accumulated from 20 patients with an age ran ge of 2 to 29 years (average, 13 years). Fourteen patients underwent p elvic osteotomy. Interviews and physical examinations confirmed that, in the long term, children with classical bladder extrophy do not have significant orthopaedic problems or disability, whether or not they u nderwent pelvic osteotomy, Radiographic imaging showed normal hip join t configuration with marked pubic diastasis, There mere no clinical pr oblems associated with the diastasis, Pelvic computed tomography studi es in 7 patients showed marked remodeling of the femora and acetabula, Radiographs of the spine showed a curve in 7 (47%) of the patients, b ut in only 3 cases was the curve larger than 10 degrees. Pelvic osteot omy is indicated during surgical correction of bladder extrophy to fac ilitate closure of the abdominal wail to prevent postoperative wound d ehiscence and possibly achieve better urinary control in older age, Ho wever there is no clear indication for pelvic osteotomy from an orthop aedic point of view.