Reduced tibial torsion in congenital clubfoot: CT measurements in 24 patients

Reikerås, Olav; Kristiansen, Leif Pål; Gunderson, Ragnhild; Steen, Harald

doi:10.1080/000164701753606699

Cited by 30 publications

(29 citation statements)

References 15 publications

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“…Although a change in femoral and tibial torsion with age in healthy children has been reported by several authors (Staheli et al 1985, Campos and Maiques 1990, Reikeras et al 2001, no correlation with age was found in children with diplegic CP in the current study. Normal torsion development is the result of muscle forces on the immature skeleton during normal gait.…”

Section: Discussioncontrasting

confidence: 74%

Passive and dynamic rotation of the lower limbs in children with diplegic cerebral palsy

Linden¹,

Hazlewood

Hillman

et al. 2006

Developmental Medicine &Amp; Child Neurology

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Rotation characteristics in gait and passive rotation of the lower limbs were evaluated retrospectively in 105 patients with diplegic cerebral palsy (65 males, 40 females; mean age 13y [SD 6y 9mo]; range 4y 4mo-40y 5mo). Of 105 patients, 22 (20.9%) required crutches, sticks, tripods, or a K-walker for their daily ambulation. Twelve (11.5%) patients used a wheelchair or buggy for community distances, e.g. shopping. Significant differences in rotational characteristics were found at the pelvis, hip, knee, and foot between left and right legs. Patients who were more affected on the right (group R, n=33) or the left side (group L, n=39) were re-evaluated. There was also a group of patients who were not asymmetrically affected (group S, n=33). In group L, maximum passive internal rotation was significantly greater on the left side, while no difference between the sides was found in group R. Peak internal rotation in gait was significantly higher on the right side in group R, but did not differ significantly between the sides in group L. Right hindfoot-thigh angle and transmalleolar axis were more external on the right, irrespective of which leg was more affected. These findings may have implications for the early non-operative management of limb posture in infants with diplegia and the surgical management of established lower extremity malrotation.

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Section: Discussioncontrasting

confidence: 74%

Passive and dynamic rotation of the lower limbs in children with diplegic cerebral palsy

Linden¹,

Hazlewood

Hillman

et al. 2006

Developmental Medicine &Amp; Child Neurology

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“…For instance, numerous studies document the association between tibial shortening, internal tibial torsion, and idiopathic clubfoot [15,18,27,31], leading some investigators to conclude idiopathic clubfoot is part of a pathologic condition affecting the entire distal lower extremity. However, Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

The Association between Idiopathic Clubfoot and Increased Internal Hip Rotation

Howlett

Mosca

Bjornson

2009

Clinical Orthopaedics &Amp; Related Research

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Clinical observation suggests the coexistence of increased internal hip rotation in limbs with clubfoot, thereby providing an additional, and perhaps overlooked, site of deformity to account for an intoeing gait in these limbs. Furthermore, assuming a genetic basis exists for exaggerated femoral and/or acetabular anteversion, which are the possible cause(s) for increased internal hip rotation, this association could provide another key to the multifactorial etiology of clubfoot. We asked whether such an association exists and retrospectively reviewed 114 children (178 clubfeet). We then tested for an association between clubfoot and increased internal hip rotation. These rotational measurements were compared with published normative data on torsion in children. In cases of unilateral clubfoot, an additional analysis compared the rotational profiles of the affected and unaffected extremities.

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“…Analysis of this domain at the item level showed that this decrease was mainly caused by an increase in the tibial rotation score. Earlier studies have shown that there is a variation in leg torsion in children with clubfoot (Cuevas de Alba et al 1998, Reikeras et al 2001, which is important in order to be able to distinguish from other causes of in-toeing. Ponseti's FAO is set to a recommended 70º of outward rotation, in contrast to our KAFO's 25º in the PCT-G.…”

Section: Discussionmentioning

confidence: 99%