Treatment of Complex Deformity of the Lower Extremities in Hypophospatemic Rickets Using a Six-Pod Frame and Fixator Assisted Plating

Proper limb alignment in hypophosphatemic rickets can be obtained using combined acute and gradual correction. Distal femoral valgus and distal tibial varus deformity were corrected with a fixator-assisted plating technique. Simultaneous deformity correction and lengthening were performed using a six-pod frame at the proximal tibia. Maintenance of proper level of serum phosphate (2.5 mg/dl) is recommended during limb lengthening of hypophosphatemic rickets patients. This case illustrates an approach to large complex multiapical and multi-segment bilateral deformity in a patient with metabolic bone disease and pathological bone.