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Journal of Bone and Joint Surgery, 1928;10:96-103.
© 1928 by The Journal of Bone and Joint Surgery, Inc

RICKETS OF THE LOWER EXTREMITIES

Its Relation to Genu Valgum and Static Flat-Foot

C. ULYSSES MOORE M.D., M.SC., F.A.C.P.

Our study demonstrates that the relation of rickets to genu valgum and static flat-foot is direct.

Signs of rickets in the bones of the head or chest at any time during the first year of life indicate that rickets of the legs and feet will probably appear during the second year and possibly again at puberty.

Roentgenograms of the legs of young animals and of children show that in early rickets the weight of the body causes the joint lines at the knee to form an acute angle instead of being parallel.

The amount of lateral mobility at the knee is an accurate index of the degree of leg rickets in the early stages and later demonstrates the progress being made toward a cure. The knee mobility arthrometer has proved a valuable and inexpensive means of taking such measurements rapidly.

These studies indicate that static flat-foot is a form of rickets. During rapidly growing periods the ends of the metatarsal bones are so soft that the formation and maintenance of a normal arch is impossible.

The presence of static flat-foot is easily determined clinically by noting the amount of inward rotation of the scaphoid bone when the patient stands "on his toes" and settles slowly back onto his heels.

Mechanical devices are helpful in curing rachitic deformities of the legs and feet which have become fixed, but do not prevent a return of the condition unless anti-rachitic therapy is administered concurrently.

Our aim in the treatment of rickets should be not only to improve the existing dyscrasia, but also to prevent its recurrence in the offspring.


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