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

Autores de IIS La Fe

• Pedro Alvedro Ruiz

  Autor

• Alberto Sanchez Garcia

  Autor

• Ivan Heredia Alcalde

  Autor

• Concepcion Lorca Garcia

  Autor

• Ana Trapero Ovejero

  Autor

• Miriam Alonso Carpio

  Autor

• Providencia Garcia Pastor

  Autor

• Salvador Pous Serrano

  Autor

• Alberto Pérez García

  Autor

Grupos

• Dermatología y Regeneración Tisular

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.

Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).

Keywords

• fibula flap; microsurgery; pelvic ring reconstruction