Complex Four Segment Multiapical Lower Extremity Deformities in Rickets Treated with Fixator Assisted Intramedullary Nailing

This is a case of severe multiapical deformity in all four segments (the bilateral femur and tibia) caused by rickets. Furthermore, the deformities were oblique plane (frontal and sagittal) as well as rotational in the axial plane. In this patient with metabolic bone disease where there was a risk of recurrence, acute deformity corrections and stabilization with IM nails were used. The case required meticulous preoperative planning, the use of intraoperative external fixators (fixator-assisted nailing (Fixator assisted nailingFAN)), multiple osteotomies, and prophylactic peroneal nerve release and leg fasciotomies.