ArticleJournal of children's orthopaedics2017
The orthopaedic management of lower limb deformity in hypophosphataemic rickets.
Article in Journal of children's orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Meta-analysis and systematic review: burosumab as a promising treatment for children with X-linked hypophosphatemia.Frontiers in endocrinology · 2024Pooled it
- Guided growth: Current concepts and novel techniques for harnessing a child's growth potential.Journal of children's orthopaedics · 2026Review
- Outcomes of hemiepiphysiodesis on lower limb deformities due to rickets: A systematic review.Journal of children's orthopaedics · 2026Review
- Clinical and radiological outcomes of using locked intramedullary nails in the treatment of severe frontal plane lower limb deformity in adolescents with hypophosphatemic rickets (mid-term results).Archives of orthopaedic and trauma surgery · 2026Article
- Experts' consensus on the management and treatment of individuals with X-linked hypophosphatemia across lifespan.Journal of endocrinological investigation · 2025Article
- Surgical treatment of the varus knee caused by vitamin D-resistant rickets. Report of two cases and review of the literature.International journal of surgery case reports · 2025Article
- A literature review of the healthcare resource use and productivity burden of X-linked hypophosphataemia.Frontiers in health services · 2025Review
- Real-World Clinical and Healthcare Resource Burden Among Burosumab-Naïve Patients With Familial Hypophosphatemia.Journal of the Endocrine Society · 2024Article
- Non-Surgical Strategies for Managing Skeletal Deformities in a Child with X-Linked Hereditary Hypophosphatemic Ricket: Insights and Perspectives.Children (Basel, Switzerland) · 2024Article
- Impact of burosumab on lower limb alignment in children with X-linked hypophosphatemia.Journal of the Pediatric Orthopaedic Society of North America · 2024Article
- X-linked hypophosphatemic rickets: from diagnosis to management.Clinical and experimental pediatrics · 2024Article
- Multi-segment osteotomy with interlocking intramedullary nail fixation in the treatment of lower limb deformity in older children with hypophosphatemic rickets.Frontiers in pediatrics · 2024Article
- Predictive factors for recurrence after lower limb deformity correction in hypophosphatemic rickets.Journal of orthopaedic surgery and research · 2023Article
- Temporary hemiepiphysiodesis using eight-plates for angular deformities of the lower extremities in children with X-linked hypophosphataemic rickets.International orthopaedics · 2023Review
- Case Report of Femoral Neck Stress Fracture in X-linked Hypophosphatemic Rachitis Patient Treated with Mechanical Axis Correction and a Literature Review.Journal of orthopaedic case reports · 2023Article
- Rickets guidance: part II-management.Pediatric nephrology (Berlin, Germany) · 2022Article
- Lower limb bone geometry in adult individuals with X-linked hypophosphatemia: an observational study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Observational
- Interdisciplinary management of FGF23-related phosphate wasting syndromes: a Consensus Statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia.Nature reviews. Endocrinology · 2022Review
- Clinical and genetic characteristics of 29 Chinese patients with X-linked hypophosphatemia.Frontiers in endocrinology · 2022Article
- Persistent Lower Limb Deformities Despite Amelioration of Rickets in X-Linked Hypophosphatemia (XLH) - A Prospective Observational Study.Frontiers in endocrinology · 2022Observational
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany patients with X-linked hypophosphataemic rickets (X-LHPR) demonstrate significant lower limb deformity despite optimal medical management. This study evaluates the use of guided growth by means of hemi-epiphysiodesis to address coronal plane deformity in the skeletally immature child.
methodsSince 2005, 24 patients with X-LHPR have been referred to our orthopaedic unit for evaluation. All patients had standardised long leg radiographs that were analysed sequentially before and after surgery if any was performed. The rate of correction of deformity was calculated based on peri-articular angles and diaphyseal deformity angles measured at regular intervals using Traumacad software. Clinical records were reviewed to obtain relevant clinical and demographic details. Statistical analysis was performed using SPSS 23 (SPSS Inc., Chicago, IL, USA).
resultsThe indication for surgical intervention was a mechanical axis progressing through Zone 2 or in Zone 3 despite one year of optimised medical treatment. The 15 patients underwent 16 episodes of guided growth (30 limbs, 38 segments) at a mean age of 10.3 years. In four limbs, surgery has only taken place recently; and in three limbs, correction is ongoing. Neutral mechanical axis was restored in 16/23 (70%) limbs: six improved and one limb (one segment) required osteotomy for residual deformity. The mean rate of angular correction per month was 0.3° for the proximal tibia and 0.7° for the distal femur. Patients with ≥ 3 years of growth remaining responded significantly better than older patients (p = 0.004). Guided growth was more successful in correcting valgus than varus deformity (p = 0.007). In younger patients, diaphyseal deformity corrected at a rate of 0.2° and 0.6° per month for the tibia and the femur, respectively. There has been one case of recurrent deformity. Patients with corrected coronal plane alignment did not complain of significant residual torsional malalignment. Serum phosphate and alkaline phosphatase levels did not affect response to surgery.
conclusionsGuided growth is a successful, minimally invasive method of addressing coronal plane deformity in X-LHPR. If coronal plane deformity is corrected early in patients with good metabolic control, osteotomy can be avoided.
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