SURGICAL-CORRECTION OF ANGULAR DEFORMITY OF THE KNEE IN CHILDREN WITHRENAL OSTEODYSTROPHY

Twenty-nine children with renal osteodystrophy (RO) and angular deform ities about the knee were studied, including 19 in whom 36 corrective operations were performed. Corrective osteotomy of the distal femur wa s performed in 20 knees, osteotomy of the proximal tibia in 11 knees, combined femoral/tibial osteotomy in three knees, and medial physeal s tapling in two knees. The indication for surgery was a deformity signi ficant enough to interfere with gait. Complications occurred in three patients and recurrence severe enough to require repeated surgery occu rred in four patients. Patients who required repeated osteotomy appear ed to have had poor metabolic control during the initial surgery, as m easured by an increased alkaline phosphatase. Surgery for children wit h RO and knee deformities is quite feasible but requires careful surgi cal planning and preoperative metabolic stabilization. Whether to corr ect the femur or tibia can be determined by evaluating full-length fil ms of the lower extremities.