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Pelvic Ring Disruption in a Patient with Bladder ExstrophyA Case Report
Brian Zirgibel, MD1; John T. Riehl, MD2; Joshua Langford, MD1
1 Orlando Health Orthopaedic Residency, 1222 South Orange Avenue, MP 43, Orlando, FL 32806. E-mail address for B. Zirgibel: bzirgibel@mac.com
2 Department of Orthopaedic Surgery, University of Louisville, 550 S. Jackson Street, ACB-First floor, Louisville, KY 40202.
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Investigation performed at Orlando Regional Medical Center, Orlando, Florida

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution(s), have had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Jun 26;3(2):e59 1-6. doi: 10.2106/JBJS.CC.L.00233
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Bladder exstrophy is an uncommon urologic condition believed to be present in one in 10,000 to 50,000 live births1,2. Patients with this condition often require extensive treatment, including multiple surgeries early in life. Identification of pelvic ring disruption in this patient population is challenging and may be complicated by anterior pelvic deficiency, pubic diastasis, external rotation of innominate bones, and previous pelvic osteotomies1. Once identified, treatment of pelvic disruption in patients with bladder exstrophy may be complicated by comorbidities and osteotomy-related pelvic deformity. We present a patient with bladder exstrophy and an anterior-posterior compression type-III (APC-III) pelvic injury sustained from a high-energy trauma. To the best of our knowledge, this is the first case report of its kind in the English-language literature. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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