Bilateral posterior pelvic resection osteotomies in patients with exstrophy of the bladder

This paper describes a modification of bilateral posterior iliac osteotomie s For bladder exstrophy, in which a strip of ilium is resected subperiostea lly lateral to the sacroiliac joints, allowing easier anterior closure with less breakdown compared with traditional osteotomies. Thirty-one children underwent repair of bladder exstrophy between 1974 and 1994, Orthopaedic pr ocedures included: closed reduction and east application in the newborn per iod (four patients), classic bilateral posterior iliac osteotomies (12 pati ents), and bilateral posterior resection osteotomies (15 patients). Dehisce nce occurred after one dosed reduction, five classic osteotomies, and one r esection osteotomy, Urinary continence was obtained in four patients who un derwent closed reduction, nine patients who underwent classic posterior ost eotomies, and nine patients who underwent posterior resection osteotomies.