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Acetabular coverage in bladder exstrophy: role of 3-dimensional computed tomography
Hani El-Mowafi1, Mohamed El-Sherbiny, Mohamed Abou-ElGhar
1Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. hanielmowafi@yahoo.com
Insights
Acetabular coverage is deficient in bladder exstrophy patients under five years old. While acetabular coverage (AC) improves with age, it remains below normal values in these patients.
Area of Science:
- Orthopedics
- Pediatric Surgery
- Radiology
Background:
- Bladder exstrophy is a congenital condition affecting pelvic development.
- Acetabular coverage is crucial for hip joint stability.
- Assessing acetabular development in bladder exstrophy is important for long-term orthopedic outcomes.
Purpose of the Study:
- To evaluate acetabular coverage (AC) and center-edge angle (CEA) in children with bladder exstrophy.
- To compare acetabular parameters in bladder exstrophy patients with age-matched controls.
- To determine the developmental trajectory of acetabular coverage in bladder exstrophy.
Main Methods:
- Retrospective analysis of 13 bladder exstrophy patients and 4 controls.
- Patients categorized into three age groups: <5, 5-10, and >10 years.
- Three-dimensional CT reconstructions used to measure AC and CEA.
Main Results:
- Bladder exstrophy patients showed significantly lower AC and CEA compared to controls (p < 0.05).
- AC values in bladder exstrophy patients increased with age but remained below normal.
- CEA values decreased with age in bladder exstrophy patients, unlike controls.
Conclusions:
- Acetabular coverage is significantly deficient in early childhood in bladder exstrophy.
- Acetabular development improves with age but does not normalize.
- Early assessment and potential interventions for acetabular development may be warranted.
Abstract:
We studied the acetabular coverage in bladder exstrophy patients and normal control children. The study included 13 patients with bladder exstrophy, who were divided according to their ages into group I below 5 years, group II between 5 and 10 years, and group III above 10 years of age. Four normal children served as controls, 2 were below 5 years, one was 7 and one was 12 years old. We measured the acetabular coverage (AC) and the center-edge-angle (CEA) by utilising the reconstructed 3-dimensional CT images. The mean right and left AC angles were 82 +/- 12 and 82 +/- 20 degrees in group-I, 107 +/- 15 and 103 +/- 17 in group-II and 119 +/- 24 and 116 +/- 22 in group-lII, respectively (p < 0.05). The mean right and left CEA angles were 33 +/- 4 and 32 +/- 4 degrees in group-I, 30 +/- 4 and 29 +/- 5 in group-II and 25 +/- 2 and 24 +/- 1 in group-III, respectively (p < 0.05). In controls, the mean right and left AC angles were 151 +/- 2 and 153 +/- 2 degrees for children below 5 years, 166 and 165 degrees in the 7 year-old child and 180 and 180 degrees in the 12 year-old child. The CEA angle ranged from 15 to 25 degrees. Acetabular coverage in bladder exstrophy patients is deficient during the first 5 years of life. Although it gradually improves over time, it does not reach to normal value.
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