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Musculoskeletal problems in association with cloacal exstrophy.

W B Greene1, L S Dias, R E Lindseth

  • 1Division of Orthopaedic Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7055.

The Journal of Bone and Joint Surgery. American Volume
|April 1, 1991
PubMed
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Cloacal exstrophy is frequently associated with significant musculoskeletal issues, including spina bifida, lower extremity paralysis, and hip/foot deformities. Tethered cord syndrome is also a common comorbidity in these patients.

Area of Science:

  • Pediatric Orthopedics
  • Developmental Biology
  • Skeletal Dysplasias

Background:

  • Cloacal exstrophy is a rare congenital anomaly with complex implications.
  • Musculoskeletal abnormalities are frequently observed in patients with cloacal exstrophy.
  • Understanding the spectrum of these issues is crucial for comprehensive patient management.

Purpose of the Study:

  • To analyze the prevalence and types of musculoskeletal problems in patients diagnosed with cloacal exstrophy.
  • To identify common comorbidities and their impact on patient outcomes.
  • To provide data for improved clinical care and surgical planning.

Main Methods:

  • Retrospective review of medical records for all patients with a cloacal exstrophy diagnosis.
  • Detailed analysis of documented musculoskeletal conditions, neurological status, and orthopedic interventions.

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  • Assessment of hip joint morphology and foot deformities.
  • Main Results:

    • All thirteen patients presented with spina bifida and persistent diastasis of the symphysis pubis.
    • Eleven patients had lipomeningocele and lower extremity paralysis; eleven also had tethered cord syndrome.
    • Common findings included hip abduction/external rotation abnormalities, mild hip dysplasia, and foot deformities, with twelve feet requiring surgical correction.

    Conclusions:

    • Cloacal exstrophy is consistently linked with diverse and severe musculoskeletal abnormalities.
    • Tethered cord syndrome and lower extremity paralysis are highly prevalent, impacting mobility.
    • Early identification and management of these orthopedic challenges are essential for optimizing functional outcomes.