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Growth Modulation for Knee Coronal Plane Deformities in Children With Nutritional Rickets: A Prospective Series With
Tamer A El-Sobky1, Shady Samir1, Mostafa M Baraka1
1Division of Paediatric Orthopaedics, Department of Orthopaedic Surgery, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Summary
Guided growth surgery effectively corrected knee deformities in children with nutritional rickets, showing significant improvement in leg alignment and function. Tibial torsion also responded well to this treatment.
Area of Science:
- Pediatric Orthopedics
- Skeletal Dysplasias
- Nutritional Deficiencies
Background:
- Nutritional rickets can cause significant coronal plane deformities around the knee in young children.
- Guided growth surgery offers a potential solution for correcting these deformities during skeletal development.
Purpose of the Study:
- To prospectively evaluate the radioclinical outcomes of guided growth surgery for knee coronal plane deformities in children with nutritional rickets.
- To assess the effectiveness of guided growth in addressing tibial torsional deformities.
- To propose a treatment algorithm for managing these conditions.
Main Methods:
- Fifty children with nutritional rickets and knee coronal plane deformities underwent temporary hemiepiphysiodesis using 8-plates.
- Radiographic parameters (mechanical axis deviation, tibiofemoral angle) and tibial torsion were measured before and after surgery.
- Follow-up included clinical assessment and serial radiographs.
Main Results:
- Statistically significant improvements were observed in all measured radiologic parameters (P ≤ 0.001).
- Radiographic improvements correlated with clinical outcomes.
- Internal tibial torsion demonstrated a strong response to the correction of coronal plane deformities.
Conclusions:
- Guided growth surgery provides rewarding radioclinical outcomes for knee deformities in nutritional rickets with a tolerable complication profile.
- Derotation osteotomies are rarely necessary as tibial torsion is responsive to guided growth.
- A proposed treatment algorithm can guide efficient growth modulation.
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