Read by QxMD icon Read

Bilateral horizontal salter osteotomies with anterior symphyseal closure using a nylon tape in the treatment of exstrophy of the bladder

Ahmad S Aly
Journal of Pediatric Orthopedics. Part B 2019 March 27
The aim of this case series study is to describe the orthopedic management of bladder exstrophy and to report on the intermediate-term outcomes following bilateral horizontal Salter osteotomies with anterior symphyseal closure using a nylon tape. This retrospective study included seven patients (five boys and two girls) who underwent bilateral horizontal osteotomies after reconstruction of the urogenital deformity using the Cantwell-Ransley technique and symphyseal closure by nylon tape number 2-5. the age range was between 7 months and 8 years (median age=17 months). Three patients had recurrent bladder exstrophy after they underwent "ramotomy" early in their life, whereas four were operated primarily. All patients were followed up over 2 years, with a mean follow-up duration of 3.27 years (2-5 years). Petrie cast was applied, with both legs abducted and internally rotated till bony union had been achieved. This allowed free handling of the wounds and catheters. Removal of k-wires was performed in an outpatient clinic after the complete union of bony osteotomies had been achieved (6-8 weeks). Satisfactory bladder closure was achieved in all patients. None of the patients had a bone infection or nonunion at the osteotomy sites. No postoperative wound dehiscence has occurred for up to 5 years. The foot progression angle improved from 37°-70° (median=45°) preoperatively to 0°-15° (median=5°) postoperatively. Symphyseal diastasis was closed well in all of our patients in postoperative plain radiography compared with 5.8-11 cm (median=8.2 cm) diastasis preoperatively. One patient had a superficial wound infection. Another patient had a sutured bladder neck by a nylon tape during the symphyseal closure. Bilateral horizontal Salter osteotomies with anterior symphyseal closure using nylon tape are safe and effective in the management of bladder exstrophy, especially in older children and in extreme diastasis (>6 cm); with improvement in the gait as it corrects the acetabular external rotation.


You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Trending on Read

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"