Hypophosphatemic Rickets with Bilateral Severe Genu Varum. Retrograde Fixator Assisted Nailing for Femurs and Double Level Tibial Osteotomies with TSF

This is a case of a skeletally mature patient with hypophosphatemic rickets and bowed legs. Rickets patients often present with multi-apical deformities, and this patient had limb deformities in all planes (coronal, sagittal, and rotational). Her case demonstrates the combination of acute and gradual correction techniques when dealing with limb deformities in both the femur and the tibia. In patients with metabolic bone disorders, intramedullary nailing can help prevent recurrence. Therefore, these patient’s femurs were treated with fixator-assisted nailings, and her tibias were treated with double-level osteotomies and circular external fixators for gradual correction.