title: Description and evaluation of operative deformity correction in calcium-deficiency rickets in Kaduna, northern Nigeria.
abstract: OBJECTIVE
  Rickets is a recurrent disease worldwide, especially in countries with limited resources (Nield et al Am Fam Physician 74(4):619-626, 2006; Thacher et al Ann Trop Paediatr 26(1):1-16, 2006). Medical therapy including orally administered calcium substitution is shown to improve a patients clinical symptoms and positively impact bone deformities, especially in the lower extremity. Even though orthopaedic intervention is necessary in a significant percentage of patients, few reports exist about operative deformity correction in patients wtih rickets.
  
  
  METHODS
  We describe our concept of operative treatment by single-stage, three-dimensional closing-wedge osteotomies on 45 deformed legs in 27 patients from the rural area of Kaduna, North Nigeria, with calcium-deficiency rickets and evaluate the early results in a 1.5-year follow-up.
  
  
  RESULTS
  We found a significant improvement in parameters of quality of life, functionality, clinical and radiological angulation and angles following the definition of Paley et al., with a complication rate of 4 % under 88 osteotomies (Paley et al Orthop Clin North Am 25(3):425-65, 1994).
  
  
  CONCLUSIONS
  The described operative therapy shows to be sufficient and with satisfactory results in correcting rickets-related leg deformities under rural circumstances with low availability of medical resources.
authors.affiliation: Department of Orthopaedics and Traumatology, Evangelisches Waldkrankenhaus Spandau, Stadtrandstraße 555, 13596, Berlin, Germany. viktor.wesselsky@pgdiakonie.de.|Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany. viktor.wesselsky@pgdiakonie.de.
authors.forename: Viktor
authors.initials: V
authors.lastname: Wesselsky
authors.affiliation: Department of Tropical Medicine, Medical Mission Hospital, Salvatorstr. 7, 97074, Würzburg, Germany.
authors.forename: Christa
authors.initials: C
authors.lastname: Kitz
authors.affiliation: Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Franz
authors.initials: F
authors.lastname: Jakob
authors.affiliation: Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Eulert
authors.affiliation: Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany. p-raab.klh@uni-wuerzburg.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Raab
mesh_terms: D000293:Adolescent; D002118:Calcium / Q000172:deficiency*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007867:Leg Bones / Q000601:surgery*; D008297:Male; D009549:Nigeria; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D012279:Rickets / Q000378:metabolism / Q000523:psychology / Q000601:surgery*; D055815:Young Adult
chemical_list: D002118:Calcium
keywords: Calcium deficiency; Correction; Deformity; Nigeria; Osteotomy; Rickets