Effect of lateral single bar knee orthoses in correction of genu varum in nutritional rickets

Abstract

Genu varum (bowlegs) is a common paediatric deformity of knee presenting as physiological variation in growth pattern. Rickets lead to more pathological bowing if occurs during the phase of physiological bowing. Apart from vitamin D restoration orthotic management doesn’t form a part of standard treatment protocol for deformities due to rickets. It is a prospective & interventional randomised comparative study conducted at department of Physical Medicine & Rehabilitation at A.I.I.P.M.R. Mumbai. Patients presenting with clinical features of rickets with bilateral genu varum were screened. Sixty participants were enrolled in the study based on inclusion & exclusion criteria and divided into 2 groups (30 each) by lottery system. Group 1 received Stoss therapy for vitamin D restoration & bilateral lateral single bar knee orthosis. Group 2 received Stoss therapy only. Participants were assessed at initial visit and 2nd, 4th & 6th month after initiation of treatment with biochemical parameters, intercondylar distance (ICD) & radiographic tibio-femoral angle. Statistically significant decrease observed in intercondylar distance & tibio-femoral angle in both groups in subsequent follow-ups. Percentage change in intercondylar distance (58.75 vs. 56.59, P = 0.457) & tibio-femoral angle (right 56.74 vs. 55.49, P = 0.599; left 60.7 vs. 59.38, P = 0.666) at the end of 3rd follow-up on comparing both groups was statistically insignificant. Vitamin D restoration by Stoss therapy can be effectively used in treatment of genu varum in nutritional rickets with or without lateral single bar knee orthoses.