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Inconsistent findings currently exist regarding the impact of vitamin D deficiency on childhood growth. This study aims to evaluate the impact of vitamin D deficiency on childhood skeletal development by exploring long bone growth in children with healed and active rickets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Forty\u2010four known\u2010age children (2 months to 12\u2009years) with rickets and 99 without rickets were compared with modern reference data from North America. Diaphyseal lengths of children with active rickets (34.1%, 15\/44), healed rickets (65.9%, 29\/44), and without rickets (99\/143, 69.2%) were expressed as a percentage of expected length and an average percentage value was calculated across all available long bones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Combined data for all six long bones revealed that children with active rickets had achieved only 75.3% of their expected size whereas, on average, children with healed rickets had achieved 81.6% of their expected size. On average, children without skeletal evidence of rickets had achieved 83.7% of their expected size. Children with severe skeletal manifestations of active rickets had a lower average percentage of expected size (70.4%) than the remainder of children affected by the condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Pronounced growth faltering existed in children with active rickets and affected the upper and lower limb, indicating systemic growth failures during the deficiency. Poor maternal health, early weaning and inadequate infant feeding, and lack of sunlight exposure likely contributed to the development of rickets. Complex interactions between pathological conditions, nutritional deficiencies and vitamin D deficiency may have exacerbated growth impacts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajpa.23687","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T15:26:58Z","timestamp":1534951618000},"page":"585-601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Endochondral growth disruption during vitamin D deficiency rickets in a mid\u201019th century series from Bethnal Green, London, UK"],"prefix":"10.1002","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-7495","authenticated-orcid":false,"given":"Rachel","family":"Ives","sequence":"first","affiliation":[{"name":"Department of Earth Sciences Natural History Museum  London The United Kingdom"},{"name":"AOC Archaeology Group  Twickenham The United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Humphrey","sequence":"additional","affiliation":[{"name":"Department of Earth Sciences Natural History Museum  London The United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-55-1-94"},{"key":"e_1_2_9_3_1","volume-title":"The pauper, the thief and the convict","author":"Archer T.","year":"1865"},{"key":"e_1_2_9_4_1","volume-title":"Metabolic bone disease and clinically related disorders","author":"Avioli L.","year":"1998"},{"key":"e_1_2_9_5_1","unstructured":"Baker T. 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