Pelvic Ring Reconstruction with an Osteocutaneous Fibula Flap for Abdominal Wall Repair in Adults with Bladder Exstrophy

Abstract Abdominal wall repair in adults with bladder exstrophy is challenging. We present a case of a 46-year-old woman with bladder exstrophy presenting with a large midline incisional hernia associated with a 13-cm hypoplasia of both pubic rami that precluded fixation of any abdominal mesh. A two...

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Bibliographic Details
Published in:Indian journal of plastic surgery 2024-07
Main Authors: Alvedro-Ruiz, Pedro, Sánchez-García, Alberto, Heredia-Alcalde, Iván, Andresen-Lorca, Belén, Trapero-Ovejero, Ana, Alonso-Carpio, Miriam, García-Pastor, Providencia, Pous-Serrano, Salvador, Pérez-García, Alberto
Format: Article
Language:English
Subjects:
Case Report
fibula flap
microsurgery
pelvic ring reconstruction
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Summary:Abstract Abdominal wall repair in adults with bladder exstrophy is challenging. We present a case of a 46-year-old woman with bladder exstrophy presenting with a large midline incisional hernia associated with a 13-cm hypoplasia of both pubic rami that precluded fixation of any abdominal mesh. A two-stage approach was adopted. First, a free vascularized osteocutaneous fibula flap was used to reconstruct the pelvic ring. After complete bone union 18 months later, a mesh was anchored to the fibula flap to restore the abdominal wall competence. After 2 years of follow-up, no hernia recurrence was observed, and the patient reported improved quality of life and self-esteem. This novel technique may provide long-term stability and good functional outcomes for reconstruction of the abdominal wall in selected adults with bladder exstrophy.
ISSN:0970-0358
1998-376X
DOI:10.1055/s-0044-1788049