Clinical tibiofemoral angle in south Indian children

Abstract

ObjectivesThe development of tibiofemoral angle in children has shown ethnic variations. However this data is unavailable for our population.MethodsWe measured the tibiofemoral angle (TFA) and intercondylar and intermalleolar distances in 360 children aged between two and 18 years, dividing them into six interrupted age group intervals: two to three years; five to six years; eight to nine years; 11 to 12 years; 14 to 15 years; and 17 to 18 years. Each age group comprised 30 boys and 30 girls. Other variables recorded included standing height, sitting height, weight, thigh length, leg length and length of the lower limb.ResultsChildren aged two to three years had a valgus angulation with a mean TFA of 1.8° (sd 0.65) in boys and 2.45° (sd 0.87) in girls. Peak valgus was seen in the five- to six-year age group, with mean TFAs of 6.7° (sd 1.3) and 7.25° (sd 0.64) for boys and girls, respectively. From this age the values gradually declined to a mean of 3.18° (sd 1.74) and 4.43° (sd 0.68) for boys and girls, respectively, at 17 to 18 years. Girls showed a higher valgus angulation than boys at all age groups.ConclusionThis study defines the normal range of the TFA in south Indian boys and girls using an easy and reliable technique of measurement with a standardised custom-made goniometer.Cite this article: Bone Joint Res 2013;2:155–61.

Development of garment with elastic straps and pressure applicator in mechanotherapy to correct children’s genu valgum

“…3 Body height was measured using a Harpender metal anthropometer to the nearest 0.1 cm, body mass was measured with minimal clothing to the nearest 0.1kg with a medical electronic scale (A&D Instruments, Ltd, Abingdon, UK), and body mass index (BMI) was calculated (BMI=kg/ m 2 ). To determine the tone, biomechanical and viscoelastic properties of skeletal muscles myometric method in multiscan mode was used.…”

“…1 In 2 to 6 year-old children, valgus knee is quite normal within certain limits of tibiofemoral angle (TFA), 2 which is defined as the angle between the anatomical axis of femur with the anatomical axis of tibia), 3 and it is expressed indirectly as intercondylar distance and intermalleolar distance (IMD). 4 Physiological GV in childhood have IMD of up to 8cm, the greatest distance being observed between 3 and 4 years, 5 disappearing gradually after the age of 7-8 years.…”

Is surgery always indicated in rachitic coronal knee deformities? Our experience in 198 knees

“…Similar studies in Indian population showed varus alignment before the age of 2 years and then valgus alignment with maximum valgus [11][12] by the age of 3-4 years and 7 -8 of valgus by the age of 7-8 years. 5 This data formed the basis of working definition for our study. It was seen that physiological varus in all studies usually disappears by 2 years of age; therefore, any varus above this age is not normal and maximum valgus achieved is usually 12 , so a value at any age higher than this was regarded as abnormal.…”

“…Studies have define normal development of tibiofemoral angle. 4,5 However, the natural history of coronal plane knee deformities due to nutritional rickets has not been described in the literature for Indian population. We undertook this study with the aim to describe the coronal plane rachitic deformities and the rate of spontaneous correction of these deformities after vitamin D admiration and to define cases where conservative management fails.…”

Bow legs and knock knees: is it physiological or pathological?

“…A positive value of TFA indicates valgus, while a varus TFA is given a negative value. 3 Following conditions alerts the physician the possibility of pathological deformity:…”