Genu valgum deformity in Hurler syndrome after hematopoietic stem cell transplantation: Correction by surgical intervention

Hematopoietic stem cell transplantation has increased the survival of patie nts with Hurler syndrome. Genu valgum occurs frequently in untransplanted p atients and has been noted in 52% of our patients after stable engraftment. No deformities spontaneously corrected. We describe the orthopaedic manage ment of genu valgum in Hurler syndrome. Medial epiphyseal stapling predicta bly affects angular deformity in these patients. Recurrence of deformities either after staple dislodgement or surgical removal can occur, and repeate d stapling may be required. Surgical epiphyseal stapling has a role in the management of genu valgum in successfully engrafted Hurler patients. We dis cuss the relationship of this skeletal deformity to other skeletal deformit ies and alternative therapies for genu valgum.