Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: One-Year Follow-Up Study

Kong, Min; Jo, Hongsik; Lee, Chang Han; Chun, Sohyun; Yoon, Chul Ho; Shin, Heesuk

doi:10.5535/arm.2018.42.1.137

Cited by 9 publications

(13 citation statements)

References 19 publications

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“…However, the details remain to be clarified. The anteversion angle of the femoral neck is large in infancy and childhood, and decreases with growth, as reported for the femoral neck shaft angle [6]. A previous study found no reduction in this angle in many patients with DDH [7], but whether the future development of OA depends on this angle in DDH-free patients remains unclear [8].…”

Section: Introductionmentioning

confidence: 80%

Unilateral premature osteoarthritis of the hip with excessive anteversion of the femoral neck developing in the early second decade: two surgical cases

Nishimura

Watanabe

Taki

et al. 2021

BMC Musculoskelet Disord

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Background Osteoarthritis (OA) of the hip rarely develops in the early second decade. As the incidence of this disease is low, no treatment method has been established. We report two patients with unilateral OA in their early teens in whom the anteversion angle of the femoral neck on the affected side was greater than that on the unaffected side. Case presentation Case 1 was an 11-year-old girl with left coxalgia and limited range of motion. There was no history of femoroacetabular impingement (FAI) or developmental dysplasia of the hip (DDH). Plain X-rays revealed the disappearance of the Y cartilage, joint space narrowing of the left hip, and acetabular/femoral head osteosclerosis. In CT images, the anteversion angle of the femoral neck (lt/rt) was 45/35 degrees. As osteoarthritis was severe, proximal femoral flexional derotational varus osteotomy (PFFDVO) and triple pelvic osteotomy (TPO) were performed. Case 2 was a 13-year-old girl with left coxalgia and limited range of motion. There was no history of FAI or DDH. Plain X-ray revealed irregularity of the left anterolateral femoral head, and a subcartilaginous cyst. In CT images, the anteversion angle of the femoral neck (lt/rt) was 30/20 degrees. As osteoarthritis was severe, PFFDVO was performed. In addition, we resected bone spurs on the femoral head because flexion was limited owing to the presence of osteophytes. In both patients, coxalgia and claudication/gait disorder resolved postoperatively, and joint space narrowing and osteosclerosis improved. However, in Case 1, there was a 3-cm difference in the leg length, and in Case 2, range-of-motion limits remained. Conclusions We present the findings in two patients with unilateral OA in their early second decade in whom the femoral anteversion angle on the affected side was greater than that on the unaffected side. PFFDVO + TPO was performed in Case 1, and PFFDVO + bone spur resection on the femoral head was performed in Case 2. Coxalgia resolved, and plain X-ray demonstrated improvements in OA; however, a difference in the leg length and range-of-motion limits remained.

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Section: Introductionmentioning

confidence: 80%

Unilateral premature osteoarthritis of the hip with excessive anteversion of the femoral neck developing in the early second decade: two surgical cases

Nishimura

Watanabe

Taki

et al. 2021

BMC Musculoskelet Disord

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“…Kong et al ., in their study of children aged 4–6 years with recently diagnosed intoeing gait, performed 3D CT at the time of diagnosis, and reported that a decrease in the FAA was observed for 18 months ( 10 ) .…”

Section: Discussionmentioning

confidence: 99%

Is there a correlation between the femoral anteversion angle and the elasticity of the hip muscles in cases of intoeing gait due to increased femoral anteversion angle?

Urfalı¹,

Tok²,

Kuyubaşi³

et al. 2022

J Ultrason

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Purpose: One of the common causes of gait disturbance in children is increased femoral anteversion. There are not enough publications in the literature on muscles related to the hip joint in increased femoral anteversion. The aim of this study was to evaluate the relationship between the femoral anteversion angle and hip muscle elasticity in children walking inward, using shear wave elastography (SWE). Material and methods: Seventeen children with bilateral increased femoral anteversion angle in computed tomography were prospectively included in this study. Elasticity values of the hip muscles (adductor magnus (adductor), iliopsoas (flexor), gluteus medius (abductor), gluteus maximus (extensor) muscles) were evaluated by ultrasound elastography by two observers. Quantitative measurements of the shear wave velocities were performed using virtual touch tissue imaging quantification. Results: There was excellent harmony between the femoral anteversion angle measurements performed by the two observers and a good congruence between the muscle elastography evaluations. While there was a moderate significant correlation between the femoral anteversion angle and the elasticity values of the iliopsoas and adductor magnus muscles, no significant correlation was found with other muscle elasticity measurements. Conclusion: Iliopsoas muscle and adductor magnus muscle elasticity are correlated with the femoral anteversion angle. With further studies, we think that physical therapy methods for the elasticity of the muscles associated with the femoral anteversion angle can reduce the complaints of the patients.

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“…Management of these patients should be carried out on an individual basis. According to the current literature, femoral anteversion decreases until 8 years of age [14]. Fabry et al .…”

Section: Discussionmentioning

confidence: 99%

Age-related decrease in supratrochanteric torsion and increase in infratrochanteric torsion in healthy pediatric femurs: an MRI study

Alpay

Özyalvaç²,

Turgut

et al. 2020

Journal of Pediatric Orthopaedics B

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The aim of the study was to evaluate the correlation between femoral anteversion, supratrochanteric torsion (STT), and infratrochanteric torsion (ITT) in healthy developing pediatric femurs using MRI. This study included 282 (164 males and 118 females) patients aged 1-18 years. The axial MRI of patients with benign tumoral lesions of the femur was retrospectively reviewed. The measurements were performed through axial images of contralateral healthy femurs. Femoral anteversion, STT, and ITT were measured twice by two orthopedic surgeons. The Pearson correlation coefficient was used to test for the correlation of age between STT, ITT, and femoral anteversion in children. All femoral anteversion, STT, and ITT measurements showed excellent intraobserver and interobserver reliability (P < 0.001). The mean STT changed from 68.5° to 37.2° ± 4.2, the mean ITT changed from −37.4° to −21.2° ± 4.2, and the mean femoral anteversion changed from 31.1° to 18.8° ± 2.2 in patients aged 1-18 years. Through the linear regression model, STT, ITT, and femoral anteversion had a significant association (P < 0.001) with age. For an increase of one year in age, the corresponding STT decreased 1.32 times (P < 0.001, R 2 = 0.510), the corresponding ITT increased 0.39 times (P < 0.001, R 2 = 0.079), and the corresponding femoral anteversion decreased 0.94 times (P < 0.001, R 2 = 0.507). ITT increases and STT decreases with age. The decrease in STT contributes more to femoral anteversion than does the increase in ITT. STT and ITT contribute to femoral anteversion with different patterns according to age.

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Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: One-Year Follow-Up Study

Cited by 9 publications

References 19 publications

Unilateral premature osteoarthritis of the hip with excessive anteversion of the femoral neck developing in the early second decade: two surgical cases

Unilateral premature osteoarthritis of the hip with excessive anteversion of the femoral neck developing in the early second decade: two surgical cases

Is there a correlation between the femoral anteversion angle and the elasticity of the hip muscles in cases of intoeing gait due to increased femoral anteversion angle?

Age-related decrease in supratrochanteric torsion and increase in infratrochanteric torsion in healthy pediatric femurs: an MRI study

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