A new orthopedic fixation method in the treatment of bladder extrophy

Extreme diastasis of the pubis and malalignment of both ilium and hip joints are always associated with the absence of infraumbilical structures and with the failure of the anterior bladder wall to close. Therefore, for a successful cure of extrophy, the pelvic ring has to be repaired, at the time of or a few days prior to the surgical cure of the bladder. The repair of the pelvis, when executed in poor aseptic conditions, results in difficult nursing problems, and fails due to the lack of convenient fixation. For these reasons, we transformed Bartons tongues into an external fixator which enhanced and improved the controlled contention of the 'vertical bilateral posterior osteotomy' of the pelvis. When a two stage procedure is decided on, the modified Bartons tongues do not interfere with the urologic surgery, and in addition, the nursing problems are alleviated. Although we have used our modified Bartons tongues in only three cases, our methodology is of low enough risk for it to be reported at this time.