Failure to diagnose and treat hypophosphatemic rickets during childhood
resulted in stunted growth and progressive deformities of the lower limb.
When the deformities were treated surgically, recurrent deformity and
non-union of osteotomies developed, and further major opeative procedures
were required to remedy these complications. Treatment from early childhood
with oral phosphate and vitamin D improved the rate of growth and
controlled the progression of bowleg deformity. Residual varus deformity
was corrected by osteotomy through the proximal tibial metaphysis at
skeletal maturity, when the results were predictable. Genu valgum deformity
was corrected by stapling the medial part of the distal femoral epiphysis
prior to skeletal maturity. With early postoperative mobilization and
adequate medication, the complications of delayed tibial union and failure
to correct the femoral valgus deformity were avoided.