Unilateral genu valgum associated to vitamin D deficiency: A multidisciplinary approach in a patient followed from 3 to 21 years - A case report.

INTRODUCTION

Lower limb postural deformities are usually bilateral and in the majority of cases tend to spontaneous correction without any treatment. On the contrary, unilateral genu valgum is a rare deformity in children, it is frequently associated with systemic pathological conditions and require a specific treatment.

PRESENTATION OF CASE

A three-year-old child affected by severe unilateral left genu valgum was followed by a multidisciplinary team. The initial treatment was medical, based on 10,000 IU of cholecalciferol every 2 months without any improvement after 6 months. Therefore, the patient was surgically treated by hemiepiphysiodesis of distal femur and proximal tibia with eight-plate obtaining a complete correction of the deformity in 10 months. Medical treatment continued for 4 years since the diagnosis. At follow-up, 18 years later, an excellent clinical result was observed.

DISCUSSION

The association between unilateral genu valgum and vitamin D deficiency is extremely rare. In case of unilateral limb deformity, it is essential to investigate the aetiology to obtain a correct diagnosis and perform a specific multidisciplinary treatment. The goal of the management is to correct the deformity and avoid any recurrence.

CONCLUSIONS

We believe that in unilateral genu valgum is always necessary a correct multidisciplinary diagnosis and treatment. The peculiarity of our case is the long-term follow-up and the absence of recurrence despite early surgical treatment. Further studies are necessary to better define the correlation between unilateral axial deformity and vitamin D deficiency.