Twenty-three-year follow-up of separated ischiopagus tetrapus conjoined twins

This paper presents a 23-year follow-up of the separation of ischiopagus tetrapus conjoined twins reported in Annals of Surgery in December 1966. One twin died of septicemia at age 2 years after bilateral pelvic osteotomies for the treatment of her marked pelvic diastasis. The surviving twin has done reasonably well, and her most significant problem is related to her musculoskeletal system. She has an increasing T7-10, L-1 apex right congenital scoliosis with wedged vertebra at T-10, as well as marked pubic diastasis and bilateral subluxation of her hips. This has resulted in a somewhat aberrant physical appearance and a "waddling" gait. Her colostomy functions well and she has normal renal and bladder function. This patient's history illustrates that many problems remain after successful separation of conjoined twins. However these problems are manageable and do not preclude the possibility that such a patient may be a productive member of society.