Deformity Correction in Child with X-Linked Hereditary Hypophosphatemic Rickets by Combined Technique (External Fixation and Flexible Intramedullary Nailing)

X-linked hereditary hypophosphatemic rickets (XHPR) is the most common form of the hypophosphatemic rickets caused by renal phosphate wasting, impaired renal production of 1,25-dihydroxyvitamin D3, and abnormal bone mineralization. Clinical orthopedic features become obvious at walking age and are manifested by varus or valgus deformities of the lower limb, torsion deformities, impaired gait, short stature, and pathologic fractures. In this case we describe a multilevel, multiplanar deformity correction using the Ilizarov method and Taylor device in association with intramedullary elastic nails in children with XHPR. The combined technique allows correction of lower limb deformities as well as a method to decrease the duration of external fixation.