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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(S 01): S111-S114
DOI: 10.1055/s-0044-1788049
Case Report

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

Pedro Alvedro-Ruiz 
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Alberto Sánchez-García
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Iván Heredia-Alcalde
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Belén Andresen-Lorca
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Ana Trapero-Ovejero 
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Miriam Alonso-Carpio
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Providencia García-Pastor
2   Abdominal Wall Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Salvador Pous-Serrano 
2   Abdominal Wall Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
,
Alberto Pérez-García
1   Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Valencia, Spain
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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.

Keywords

microsurgery - fibula flap - pelvic ring reconstruction


Publication History

Article published online:
04 July 2024

© 2024. 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/)

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