Abstract
We report the results of application of a strategy for deformity correction in hypophosphataemic rickets using careful preoperative planning, multiple osteotomies where appropriate and acute or gradual correction using internal or circular external fixation or a combination.
7 patients with 25 limb segments (14 femur and 11 Tibia) had deformity correction with either intramedullary nailing (10 Femur and 3 Tibia) or llizarov ring fixator (4 femur and 8 Tibia). The average age was 18 years (7–39 years), 5 were female and 2 male, had an average follow up of 36 months (10–77 months). All patients had adequate control of rickets pre operatively.
Clinical examination and analysis of pre and post-operative X-rays were carried out by an observer not involved in the surgical procedures. Standardised X-rays were analysed using the method of Paley and Tetsworth (Clin Orthop 280 48–71. 1992).
Satisfactory correction of deformity was achieved in both frontal and sagittal plane. There were total 8 episodes of soft tissue infection with no long-term consequence. Average ankle ROM was 7–44 and knee ROM was 0–128. There is no recurrence of the deformity.
All patients were happy with outcome and are prepared to undergo same treatment if required, even though some were restricted in terms of sport and leisure activities.
We conclude that satisfactory correction of deformity in VDRR can be achieved and maintained with nailing or llizarov fixator in short term with minimal complications, no recurrence and excellent outcome.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin
