Editing Rickets (section)

==Treatment==
===Diet and sunlight===
[[Image:Cholecalciferol.svg|thumb|100px|[[Cholecalciferol]] (D<sub>3</sub>)]]
[[Image:Ergocalciferol.svg|thumb|100px|[[Ergocalciferol]] (D<sub>2</sub>)]]
Treatment involves increasing dietary intake of calcium, phosphates and vitamin D. Exposure to ultraviolet B light (most easily obtained when the sun is highest in the sky), [[cod liver oil]], halibut-liver oil, and [[Ergosterol|viosterol]] are all sources of vitamin D.<ref>{{cite journal | vauthors = Lamberg-Allardt C | title = Vitamin D in foods and as supplements | journal = Progress in Biophysics and Molecular Biology | volume = 92 | issue = 1 | pages = 33–38 | date = September 2006 | pmid = 16618499 | doi = 10.1016/j.pbiomolbio.2006.02.017 | series = UV exposure guidance: A balanced approach between health risks and health benefits of UV and Vitamin D. Proceedings of an International Workshop, International Commission on Non-ionizing Radiation Protection, Munich, Germany, 17–18 October 2005 | doi-access = free }}</ref>

A sufficient amount of ultraviolet B light in sunlight each day and adequate supplies of calcium and phosphorus in the diet can prevent rickets. Darker-skinned people need to be exposed longer to the [[ultraviolet|ultraviolet rays]]. The replacement of vitamin D has been proven to correct rickets using these methods of ultraviolet light therapy and medicine.<ref name="History"/>

Recommendations are for 400 [[international unit]]s (IU) of vitamin D a day for infants and children. Children who do not get adequate amounts of vitamin D are at increased risk of rickets. Vitamin D is essential for allowing the body to uptake calcium for use in proper bone calcification and maintenance.<ref>{{cite web |title=Rickets -- Symptoms and Causes |url=https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943 |website=Mayo Clinic Patient Care and Health Information |publisher=Mayo Clinic |access-date=27 January 2022}}</ref>

===Supplementation===
Sufficient vitamin D levels can also be achieved through dietary supplementation and/or exposure to sunlight. Vitamin D<sub>3</sub> ([[cholecalciferol]]) is the preferred form since it is more readily absorbed than vitamin D<sub>2</sub>. Most [[dermatology|dermatologists]] recommend vitamin D supplementation as an alternative to unprotected ultraviolet exposure due to the increased risk of [[skin cancer]] associated with sun exposure. Endogenous production with full body exposure to sunlight is approximately 250&nbsp;μg (10,000 IU) per day.<ref name="Vieth">{{cite journal | vauthors = Vieth R | title = Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety | journal = The American Journal of Clinical Nutrition | volume = 69 | issue = 5 | pages = 842–856 | date = May 1999 | pmid = 10232622 | doi = 10.1093/ajcn/69.5.842 | doi-access = free }}</ref>

According to the [[American Academy of Pediatrics]] (AAP), all infants, including those who are exclusively breast-fed, may need vitamin D supplementation until they start drinking at least {{convert|17|USfloz|ml}} of vitamin D-fortified milk or formula a day.<ref>{{cite journal | vauthors = Gartner LM, Greer FR | title = Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake | journal = Pediatrics | volume = 111 | issue = 4 Pt 1 | pages = 908–910 | date = April 2003 | pmid = 12671133 | doi = 10.1542/peds.111.4.908 | doi-access = free }}</ref>

Despite this recommendation, a recent [[Cochrane (organisation)|Cochrane]] [[systematic review]] has found limited evidence that vitamin D plus calcium, or [[Calcium in biology|calcium]] alone compared to vitamin D improves healing in children with nutritional rickets.<ref>{{cite journal | vauthors = Chibuzor MT, Graham-Kalio D, Osaji JO, Meremikwu MM | title = Vitamin D, calcium or a combination of vitamin D and calcium for the treatment of nutritional rickets in children | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | issue = 4 | pages = CD012581 | date = April 2020 | pmid = 32303107 | pmc = 7164979 | doi = 10.1002/14651858.CD012581.pub2 | collaboration = Cochrane Metabolic and Endocrine Disorders Group }}</ref>

===Surgery===
Occasionally surgery is needed to correct severe and persistent deformities of the lower limbs, especially around the knees namely [[genu varum]] and [[genu valgum]]. Surgical correction of rachitic deformities can be achieved through osteotomies or guided growth surgery. Guided growth surgery has almost replaced the use of corrective osteotomies. The functional results of guided growth surgery in children with rickets are satisfactory. While bone osteotomies work through acute/immediate correction of the limb deformity, guided growth works through gradual correction.<ref name= JAAOSGlobal/>