Deformity correction by external fixation and/or intramedullary nailing in hypophosphatemic rickets.
BACKGROUND
There are many modalities of treatment for complex lower extremity deformity in hypophosphatemic rickets. We evaluated the outcomes of deformity correction using an external fixation and/or intramedullary nailing in hypophosphatemic rickets.


METHODS
55 segmental deformities (20 femora, 35 tibiae) from 20 patients were examined retrospectively. There were 9 children and 11 adults. Distraction osteogenesis was used in 28 segments and acute deformity correction in 27. External fixation was applied in 24 segments, intramedullary nailing in 6, and external fixation and intramedullary nailing in 25.


RESULTS
There were 18 major and 13 minor complications in 26 of 28 segments with distraction osteogenesis, and 13 major and 10 minor complications in 19 of 27 segments with acute correction. Recurrent deformity or refracture occurred in 10 of 21 segments with distraction osteogenesis by external fixation only, 4 of 6 with acute correction by intramedullary nailing, and 1 of 25 with distraction osteogenesis or acute correction by external fixation and intramedullary nailing. Nail-related complications occurred in 3 of 6 with intramedullary nailing and 2 of 25 with external fixation and intramedullary nailing.


CONCLUSIONS
External fixation and intramedullary nailing can be recommended to prevent complications during or after deformity correction in hypophosphatemic rickets.
Song
Hae-Ryong
HR
Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea. songhae@korea.ac.kr
Soma Raju
V V J
VV
Kumar
Satish
S
Lee
Seok-Hyun
SH
Suh
Seung-Woo
SW
Kim
Jung-Ryul
JR
Hong
Jun-Seok
JS
D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D002648:Child; D016267:External Fixators; D005260:Female; D005269:Femur / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007015:Hypophosphatemia, Familial / Q000150:complications / Q000601:surgery*; D008297:Male; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome