title: Fascia lata and early spica casting as adjuncts in closure of bladder exstrophy.
abstract: Correction of the skeletal defect seen in the exstrophy complex consists of reconstitution of the pelvic ring. Long-term success depends upon the formation of a fibrous union between the pubes. When this union does not occur diastasis of the pubis results. Long-term urological success appears to be related to adequate pubic approximation. We used fascia lata to construct an anterior pelvic ligament between the pubic bones in 7 patients. In the 6 patients for whom followup is available the fascia lata has persisted and appears to be viable histologically on biopsy specimens obtained at a subsequent operation. Because the fascia lata holds the pubis together so well we have been able to cease Bryant's traction in children by 2 weeks and place them into a cast. This has resulted in early discharge from the hospital in all patients. For these reasons we believe that fascia lata is a useful adjunct in the armamentarium of materials used to reapproximate the pubis.
authors.affiliation: Children's Hospital and Health Center, San Diego, California.
authors.forename: H C
authors.initials: HC
authors.lastname: Scherz
authors.forename: G W
authors.initials: GW
authors.lastname: Kaplan
authors.forename: D H
authors.initials: DH
authors.lastname: Sutherland
authors.forename: M G
authors.initials: MG
authors.lastname: Packer
mesh_terms: D001746:Bladder Exstrophy / Q000601:surgery*; D002370:Casts, Surgical; D005205:Fascia / Q000637:transplantation*; D005206:Fascia Lata / Q000637:transplantation*; D006801:Humans; D007223:Infant; D008022:Ligaments / Q000601:surgery; D008722:Methods; D011182:Postoperative Care; D011630:Pubic Bone / Q000002:abnormalities / Q000601:surgery*