Journal Contents   |    
View Disclosures and Other Information
From the Department of Orthopedic Surgery, College of Medicine, State University of Iowa, Iowa City
1964 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1964 Jul 01;46(5):935-958
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


The regulation of vitamin-D dosage by means of twenty-four-hour urinary calcium values is relatively simple and requires no unusual laboratory procedures. If carefully applied, partial roentgenographic healing can occur and this status can be maintained permitting a nearly normal rate of growth and avoidance of hypervitaminosis D.

The importance of avoiding hypervitaminosis D is stressed. Repeated swings from hypovitaminosis to hypervitaminosis D merely alternates one disturbance of bone metabolism for another; both deplete the skeleton. Adequate therapy must maintain the child as nearly normal as possible, despite the chronic hypophosphatemia.

Under adequate vitamin-D therapy the leg deformities may improve but in our cases did not correct completely. Surgical correction is usually necessary. However, this is indicated only after regulation with adequate vitamin-D therapy. The deformities often recur if the therapy is interrupted or is grossly inadequate.

The parents are always warned that this is a chronic metabolic disease which must be followed throughout life and is especially hazardous during growth for the prevention of deformities and the maintenance of a normal rate of growth, but may recur in later years. The general practitioner should also be informed that children whose rickets does not heal promptly with customary doses of vitamin D are not suffering from simple rickets and should be referred to clinics where their disease can be treated and followed adequately.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


    rickets ; vitamin d
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Results provided by:
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    LA - Ochsner Health System
    IL - The University of Chicago's Department of Orthopaedic Surgery and Rehabilitation Medicine
    CT - Orthopaedic Foundation
    VA - OrthoVirginia