Surgical management of rickets-like bone deformities (knock-knee and bow-leg) in children in sub-Saharan Africa

Abstract

Rickets-like deformities of the lower limb (knock- knee or bow-leg) are very frequent in sub-Saharan Africa. A prospective study was carried out over a period of 5 years. Forty-eight children were treated surgically for rickets-like deformities. The surgical technique was guided growth using a tension-band plate (eight plate). One patient was lost to follow- up. The technique failed in two cases (absence of correction in one case and hypercorrection in one case). Five patients are still under follow-up with progressive correction and were excluded from the study. A full correction was achieved in 40 patients (73 knees). There were 33 bilateral and 7 unilateral deformities. The deformities were knock-knees in 20 cases, bowlegs in 18 cases and there were 2 windswept deformities Good correction was obtained after a mean time of 11.4 months for genu varum and after a mean time of 12.4 months. The two windswept deformities were corrected after 8 and 9 months respectively. The guided growth technique using eight plate is effective as well in Africa. The needed material is not expensive if a two-hole tubular plate is used with two 3.5 screws.