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Hip function and gait in patients treated for bladder exstrophy

D Sutherland1, L Pike, K Kaufman

  • 1University of California, San Diego.

Journal of Pediatric Orthopedics
|November 1, 1994
PubMed
Summary
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Iliac osteotomy in bladder exstrophy patients does not improve gait abnormalities. This procedure, however, remains crucial for enhancing genitourinary repair outcomes in children with this condition.

Area of Science:

  • Pediatric Orthopedics
  • Developmental Biology
  • Reconstructive Surgery

Background:

  • Bladder exstrophy commonly presents with pubic diastasis and altered pelvic anatomy.
  • The necessity of iliac osteotomy for correcting gait disturbances in these patients is debated.

Purpose of the Study:

  • To identify hip pathology and gait abnormalities in bladder exstrophy patients.
  • To assess the impact of iliac osteotomy on gait in this population.

Main Methods:

  • Retrospective review of pelvic radiographs and gait analyses in 15 children with bladder exstrophy.
  • Comparison of patients who underwent bilateral iliac osteotomy (9/15) versus those who did not.

Main Results:

  • No significant hip subluxation or dislocation was observed; minor hip dysplasia was noted in two patients.

Related Experiment Videos

  • Pubic diastasis progression was age-dependent and unrelated to osteotomy.
  • Reduced passive hip internal rotation was present, but not correlated with pubic diastasis.
  • Increased lower extremity external rotation during gait was common (10/15), but a gluteus medius lurch was absent.

    • Conclusions:

    • Iliac osteotomy does not appear to influence gait patterns in children with bladder exstrophy.
    • The procedure is still recommended for optimizing genitourinary repair results.