Bilateral transverse iliac osteotomy in the correction of neonatal bladder extrophies.

In a clinical and radiological study of seven neonates with bladder extrophy (BX), separation of pubic bones from the midline, lateral and caudal tilting of the iliac alae and external rotation of the acetabula, with consequent early predisposition to bilateral congenital hip dislocation (CHD), who were treated by a combined bilateral innominate osteotomy and reconstruction of the urinary bladder, there were only two failures due to CHD and three due to BX, which were dealt with at a later session. Although the bilateral transverse iliac osteotomy procedure is very rarely, if ever, employed in the neonatal period, it may well be combined with the reconstructive surgical procedures that involve pelvic skeletal structures while dealing with soft tissue procedures. Bilateral transverse iliac osteotomy was preferred to the conventional two-stage posterior iliac vertical osteotomies because of its easiness and the simple approach provided by the supine positioning of the patient.