Study on the Healing and Correction of Rachitic Leg Deformity

Kim, Hyung Soon; Shim, Jae Hyoung

Abstract

Eighty three rickets could be diagnosed at our department during eight years from August of 1969 to July of 1977. Among them fourteen children, whose radiographs and clinical description were precise with well-documented follow-up study of more than one year, were subjected to this analysis. Evaluation of the healing and correction of the lower leg deformity in these rachitic children obtained the following results. 1. Among fourteen rachitic children, thirteen patients (26 legs) showed varus and one patient (2 legs) showed valgus deformity. 2. Mean mechanical tibio-femoral angle showed shift from the initial 16.1°±5.3° to 5.5°+4.0° at final visit, which indicated the gradual correction of the deformity with the advance of the ages of children. The follow-up study after three years in this series showed that the correction became almost complete. 3. At the epiphyseo-metaphyseal region of the distal femur, the initial angle showed two distinct trends of change. The initial varus angle more than 7 or 8 showed the decrease at the later follow-up study, while the initial angle less than 7 or 8 showed the increase. 4. The epiphyseo-metaphyseal region of the proximal tibia showed the minimum change of angle. Mean angle of deviation from the vertical line was 3.7°±2.9° at first visit and 2.6°± 2.4°at final visit. The least degree of varus and the trend toward valgus observed in this region may refiect its compensatory activity against the varus deformity of the leg as a whole. 5. The epiphyseo-metaphyseal region of the distal tibia showed the maximum degree of varus at both initial and final check although the greatest degree of correction was attained. The initial mean varus angle of 23.9°±9.2° became 12.9°±7.1° at final visit. 6. The results of this study have shown that the correct evaluation of the rcchitic leg deformity is possible with measurement of the mechanical tibio-femoral angle and that the deviation angle of each epipyseo-metaphyseal region is preferable.