Surgical Indications in Hypophosphataemic Rickets.

Area of Science:

• Pediatric Endocrinology
• Orthopedic Surgery
• Nephrology

Background:

• Hypophosphatemic rickets results from impaired renal phosphate reabsorption, leading to low blood phosphate levels.
• This condition causes significant bone metabolism alterations, including increased osteoclast activity, leading to bone deformities, fragility, and impaired growth.
• Manifestations include delayed growth, bone pain, microfractures, and frequent fractures.

Purpose of the Study:

• To review surgical indications for managing hypophosphatemic rickets.
• To highlight the spectrum of surgical approaches, from conservative to aggressive, for bone deformities and osteomalacia.

Main Methods:

• Review of current literature and clinical practices regarding surgical management of hypophosphatemic rickets.
• Categorization of surgical techniques based on deformity severity and patient age.

Main Results:

• Conservative management is often sufficient, but surgical intervention is indicated for significant bone deformities or severe osteomalacia.
• Surgical options range from minimally invasive guided growth techniques for less severe deformities to corrective osteotomies for complex, three-dimensional deformities.

Conclusions:

• Surgical intervention plays a crucial role in correcting deformities and improving outcomes in patients with hypophosphatemic rickets.
• A tailored approach, considering both aggressive and non-aggressive surgical strategies, is essential for optimal patient care.