What is the role of surgery in the treatment of hypophosphatemic rickets?

Updated: May 02, 2018
  • Author: James CM Chan, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

Osteotomy to realign extremely distorted leg curvatures may be necessary for children whose diagnosis was delayed or whose initial treatment was inadequate. Skull deformity may require treatment for synostosis. [12]  Spontaneous abscesses often require periodic dental procedures.

A retrospective study by Gizard et al suggested that in patients with X-linked hypophosphatemic rickets, corrective surgery for leg bowing performed before puberty carries an increased risk that the limb deformity will recur. In the study, patients underwent osteotomy and bone alignment (with the exception of three transient hemiepiphysiodesis procedures). Fourteen out of 49 patients (29%) experienced recurrence, with the number of additional surgeries required being highest in individuals who underwent their first surgery before age 11 years and lowest in those whose first surgery was performed after age 15 years. [28]


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