Spica casting compared to Bryant's traction after complete primary repair of exstrophy: safe and effective in a longitudinal cohort study

The Journal of Urology
Margarett ShnorhavorianRichard W Grady

Abstract

Bryant's traction is the most commonly used method for immobilization after bladder exstrophy repair. We hypothesized that spica casting is a safe and effective alternative to Bryant's traction after complete primary repair of exstrophy. Complete primary repair of exstrophy was performed for initial repair in 39 consecutive children by all surgeons at Seattle Children's Hospital since 1998. Three sequential cohorts were evaluated-Bryant's traction without osteotomy (13 patients), spica casting without osteotomy (14) and spica casting with osteotomy. These 3 sequential cohorts represent eras of care and an evolution of practice. Primary outcomes included major complications related to immobilization, dehiscence, urinary incontinence and length of stay. We defined complications of immobilization as nonunion of pelvic osteotomy, femoral nerve palsy, revision of spica cast requiring return to the operating room, infection at the osteotomy site and activity limiting pain at the osteotomy site. Fisher's exact test or t test was used to determine statistical significance. There was no difference in urinary continence (p = 0.09). Use of Bryant's traction was associated with double the length of stay (p >0.001). There was no correlation...Continue Reading

References

Feb 1, 1993·Journal of Pediatric Surgery·D A HusmannB M Churchill
May 8, 2000·The Journal of Urology·C OzcanA Gökdemir
Feb 24, 2001·The Journal of Bone and Joint Surgery. American Volume·P D SponsellerJ P Gearhart
Jun 27, 2003·Journal of Pediatric Orthopedics·Gbolahan O OkubadejoJohn P Gearhart
Jan 26, 2005·Urology·Ranjiv Mathews, John P Gearhart
Sep 9, 2005·The Journal of Urology·John P Gearhart, Andrew D Baird
Jan 27, 2006·Journal of Pediatric Orthopedics. Part B·Shinichi SatsumaMasahiro Kurosaka
May 25, 2006·The Journal of Bone and Joint Surgery. British Volume·D JonesH S Hosalkar
Jun 14, 2006·Journal of Pediatric Surgery·Caleb P NelsonJohn P Gearhart
Jun 15, 2007·Current Opinion in Urology·Patricio C Gargollo, Joseph G Borer
Aug 21, 2007·The Journal of Urology·John P GearhartCaleb P Nelson
Aug 21, 2007·The Journal of Urology·Brian A VanderBrinkMoneer K Hanna
Aug 1, 1906·Annals of Surgery·F Trendelenburg
Jul 23, 2008·Journal of Pediatric Urology·Sabine Kost-ByerlyJohn P Gearhart
Aug 20, 2008·The Journal of Urology·Margarett ShnorhavorianMichael E Mitchell
Aug 22, 2008·The Journal of Urology·Anthony J SchaefferJohn P Gearhart
Oct 25, 2008·Journal of Pediatric Urology·A D BairdJ P Gearhart
Oct 25, 2008·Journal of Pediatric Urology·A D BairdJ P Gearhart
Feb 26, 2009·Current Urology Reports·Richard W Grady

❮ Previous
Next ❯

Citations

Jul 23, 2013·The Journal of Urology·I MushtaqP Cuckow
Jul 3, 2013·The Journal of Urology·M Chad WallisPatrick C Cartwright
Oct 11, 2016·The Journal of Urology·Pokket SirisreetreeruxJohn P Gearhart
Feb 25, 2017·Current Urology Reports·Elizabeth RothTravis Groth
Sep 3, 2011·The Journal of the American Academy of Orthopaedic Surgeons·Neil C ViningRichard W Grady

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aneurysm

Aneurysms are outward distensions or bulges that occurs in a weakened wall of blood vessels. Discover the latest research on aneurysms here.

Bladder Carcinoma In Situ

Bladder Carcinoma In Situ is a superficial bladder cancer that occurs on the surface layer of the bladder. Discover the latest research on this precancerous condition in this feed.