Javed Iqbal.
An experience of surgical management of Fluorosis.
Pak J Pathol Jan ;12(3):103-6.

From July 2000 to September 2000, 174 children from the villages of Manga Mandi area were admitted in the Pediatric Orthopaedic Department of The Children Hospital and The Institute of Child Health, Lahore with bone deformities tar clinical evaluation, investigation and treatment. All patients on dental and radiological examination of bones had sufficient evidence of fluorosis. twenty-seven patients had severe deformities of lower extremities, requiring surgery. Sixteen operations in fourteen patients were carried out for genu valgus. The age range of the patients was between 6 to 16 years, mean age was 11 years and 2 months. Nine (G%) cases had proximal tibial osteotomy, while seven (44%) had supracondylar femoral osteotomy. The osteotomy was fixed with Ilizarov external fixator. There was pin track infection in 75% patients, which resolved with oral antibiotics. There was neurological deficit in 8.2% cases, which made partial recovery. The external fixator was removed when there was sufficient evidence of radiological healing. The mean bone healing time was three months and one week. There was no non-union. The clinical and radiological evidence was more suggestive of fluorosis compounded by micronutrient deficiency but it did not seem to have significant un-toward effects on correction of deformity & healing of the bones.

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