Viktor Wesselsky1,2, Christa Kitz3, Franz Jakob4, Jochen Eulert4, Peter Raab5. 1. Department of Orthopaedics and Traumatology, Evangelisches Waldkrankenhaus Spandau, Stadtrandstraße 555, 13596, Berlin, Germany. viktor.wesselsky@pgdiakonie.de. 2. Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany. viktor.wesselsky@pgdiakonie.de. 3. Department of Tropical Medicine, Medical Mission Hospital, Salvatorstr. 7, 97074, Würzburg, Germany. 4. Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany. 5. Department of Orthopaedics, University of Wuerzburg, König-Ludwig-Haus, Brettreichstr. 11, 97074, Würzburg, Germany. p-raab.klh@uni-wuerzburg.de.
Abstract
PURPOSE: 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). CONCLUSION: 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.
PURPOSE: 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). CONCLUSION: 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: Thierry Craviari; John M Pettifor; Tom D Thacher; Craig Meisner; Josiane Arnaud; Philip R Fischer Journal: J Health Popul Nutr Date: 2008-03 Impact factor: 2.000
Authors: V S Braithwaite; R Freeman; C L Greenwood; D M Summers; S Nigdikar; C B D Lavy; A C Offiah; N J Bishop; J Cashman; A Prentice Journal: Osteoporos Int Date: 2016-04-08 Impact factor: 4.507