Rotational profile of lower extremities in bladder exstrophy patients withunapproximated pelvis: A clinical and radiologic study in children older than 7 years

Fourteen patients (nine boys, five girls) with bladder exstrophy were analy zed radiologically and clinically. All were older than 7 years and had a pu bic diastasis >2 cm. Anteroposterior and lateral center-edge angles were me asured by direct radiography. Acetabular version, femoral anteversion, tibi al torsion angles, and patellofemoral congruency angle were measured by com puted tomography imaging. All were active with regard to their daily life a nd sports activities. The average foot-progression angle was +8 degrees. Sp herical congruency was present in all hips, and none showed dysplasia. The average angle of acetabular version was apparently less than normal, but fe moral anteversion angles were found to be increased. Increased external tib ial torsion was observed in all patients. Twelve (71%) of 14 patients had p ositive congruence angles, the average being +6.1 degrees. Two patients had subjective complaints of patellofemoral instability. Increased femoral ant eversion and external tibial torsion may lead to patellofemoral instability , and the bladder exstrophy patients should be followed up regarding this p roblem as well.