Morphological and Functional Hip Long-Term Results after Exstrophy Repair.
Michael Amir Kertai1, Wolfgang H Rösch2, Roland Brandl3
1Department of Pediatric Surgery, Klinik St. Hedwig, University Medical Center Regensburg, Regensburg, Germany.
Summary
Long-term hip function in exstrophy-epispadias complex (EEC) patients is generally good after newborn symphysis approximation without osteotomy. Most patients show no significant hip dysplasia or degenerative disease, with excellent functional scores.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Developmental abnormalities
Background:
- Exstrophy-epispadias complex (EEC) is associated with bony pelvis abnormalities.
- Long-term orthopedic consequences and hip function in EEC patients are not well-documented.
- Understanding long-term outcomes is crucial for patient management.
Purpose of the Study:
- To investigate clinical and radiological results in EEC patients with long-term follow-up.
- To assess hip function and orthopedic consequences after early symphysis approximation without osteotomy.
- To evaluate the relationship between EEC-related pelvic morphology and hip health.
Main Methods:
- Cross-sectional study of 17 postpuberty EEC patients (mean age 18.2 years).
- Standardized radiography, clinical examination, and Harris hip score were used.
- Patients underwent symphysis approximation without osteotomy in early childhood.
Main Results:
- Mean pubic diastasis was 5.1 cm; borderline hip dysplasia in 4 patients.
- No severe hip dysplasia, subluxation, or luxation; one patient had early arthrosis.
- Excellent functional hip scores (Harris hip score) with no significant pain or activity restriction.
Conclusions:
- Symphysis approximation without osteotomy in EEC patients leads to good long-term hip function.
- Pelvic morphology in EEC does not necessarily result in impaired hip function.
- Postnatal ultrasound screening for hip dysplasia is recommended in EEC patients.
