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Deformity Correction of Knee and Leg Lengthening by Ilizarov Method in Hypophosphatemic Rickets: Outcomes and Significance of Serum Phosphate Level

Choi, In Ho M.D.*; Kim, Jae Kwang M.D.*; Chung, Chin Youb M.D.*; Cho, Tae-Joon M.D.*; Lee, Seok Hyun M.D.†; Suh, Seong Woo M.D.†; Whang, Kuhn Sung M.D.‡; Park, Hui Wan M.D.§; Song, Kwang Soon M.D.∥

Journal of Pediatric Orthopaedics:
Lower Limb

The authors evaluated 14 patients with hypophosphatemic rickets who underwent correction of a knee deformity along with a leg lengthening by the Ilizarov method. Deformity correction alone was performed in 8 femora and 4 tibiae-fibulae, and concomitant deformity correction and limb lengthening (>1.0 cm) in 9 femora and 19 tibiae-fibulae. The healing index correlated with the biochemical parameters. Knee deformities were satisfactorily corrected in all patients except one. There was a statistically significant negative correlation between the healing index and the serum phosphate level: those who had a serum phosphate level higher than 2.5 mg/dL showed a relatively rapid regenerate bone healing compared with those with less than 2.5 mg/dL. The authors conclude that a serum phosphate level of 2.5 mg/dL as a cut-off point should be considered in deciding whether deformity correction alone or with a concomitant leg lengthening should be undertaken.

Author Information

Study conducted at Seoul National University Children's Hospital and Clinical Research Institute, Seoul National University Hospital, Seoul, Korea

From the *Departments of Orthopaedic Surgery, Seoul National University Children's Hospital; †Korea University Hospital; ‡Hanyang University Hospital; §Yonsei University Yongdong Severance Hospital, Seoul; and ∥Keimyung University Hospital, Taegu, Korea.

Address correspondence and reprint requests to In Ho Choi, M.D., Department of Orthopaedic Surgery, Seoul National University Children's Hospital, 28 Yongon-dong Chongno-gu, Seoul 110–744, Korea (e-mail:

None of the authors received financial support for this study.

© 2002 Lippincott Williams & Wilkins, Inc.