Current techniques of medical management have extended the lives of many uremie children. Five patients with azotemic osteodystrophy are reported, four of whom underwent successful reconstructive orthopaedic surgery. The selection of patients with azotemic osteodystrophy for surgery includes considerations of life expectancy, effectiveness of medical management in controlling the metabolic bone disease, surgical risk, and the amenability of the orthopaedic disorder to definitive surgical procedures. Successful operative management of these patients requires careful and close medical supervision by physicians skilled in the treatment of uremia. The management of some specific paraoperative problems requires the close cooperation of surgeon, anesthetist, and pediatrician.
Bone healing time was normal in these patients.