Rotational profile of lower extremities in bladder exstrophy patients with unapproximated pelvis: a clinical and radiologic study in children older than 7 years.

Fourteen patients (nine boys, five girls) with bladder exstrophy were analyzed radiologically and clinically. All were older than 7 years and had a pubic diastasis >2 cm. Anteroposterior and lateral center-edge angles were measured by direct radiography. Acetabular version, femoral anteversion, tibial torsion angles, and patellofemoral congruency angle were measured by computed tomography imaging. All were active with regard to their daily life and sports activities. The average foot-progression angle was +8 degrees . Spherical congruency was present in all hips, and none showed dysplasia. The average angle of acetabular version was apparently less than normal, but femoral anteversion angles were found to be increased. Increased external tibial torsion was observed in all patients. Twelve (71%) of 14 patients had positive congruence angles, the average being +6.1 degrees . Two patients had subjective complaints of patellofemoral instability. Increased femoral anteversion and external tibial torsion may lead to patellofemoral instability, and the bladder exstrophy patients should be followed up regarding this problem as well.