The measurement of tibial torsion by magnetic resonance imaging in children: the comparison of three different methods

Başaran, Serdar Hakan; Erçin, Ersin; Bayrak, Alkan; Cumen, Huseyin; Bilgili, Mustafa Gökhan; İnci, Ercan; Avkan, Mustafa Cevdet

doi:10.1007/s00590-015-1694-2

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…In the group of reduced FT as well as in the group of excessive FT, tibial torsion can be considered as normal with a mean torsion of 29 ± 7° and 33 ± 5° respectively, although the range of so called normal tibial torsion is wide with mean values in the literature of 19–40°. 22,34–36 The difference of tibial torsion of the 2 groups was not significant ( p = 0.158) supporting the results of Reikerås et al, 36 who found no compensatory external rotation of the lower leg in cases of increased FT. Also Waidelich et al 35 found no correlation between femoral and tibial torsion. In contrast to these results, Tönnis and Heinecke 1 suspected a relationship between rotation of femur and tibia.…”

Section: Discussionsupporting

confidence: 67%

“…The angle (°) between these 2 lines was defined as FT. Tibial torsion was assessed by measuring the angle (°) between a tangent on the posterior tibia on the first axial slice where the fibular head was visible and a line connecting the centres of the anteroposterior diameters of the two malleoli at the level of the ankle joint. 21,22 Tuberosity to trochlear groove distance (TTTG), patellar tilt and patella bisect offset were measured on transverse MRI images. TTTG was defined as the distance (mm) between a line through the deepest point of the trochlear groove and the centre of the tuberosity keeping both lines perpendicular to the tangent of the posterior condyles.…”

Section: Methodsmentioning

confidence: 99%

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Subtrochanteric rotational osteotomy for young adults with hip pain due to femoral maltorsion

2020

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Introduction: Femoral rotational osteotomies can be a treatment option for symptomatic femoral maltorsion. This study investigated the clinical and radiological results of subtrochanteric rotational osteotomy and its potential adverse effects, particularly on patellofemoral stability and geometry. Methods: Retrospective consecutive series of patients undergoing subtrochanteric rotational osteotomy with hip arthroscopy. 25 hips, 18 with decreased (⩽4°), 7 with increased (⩾28°) femoral torsion (FT), were analysed. Mean follow-up was 37 months. Subjective Hip value (SHV), WOMAC and Harris Hip Score (HHS), hip range of motion, asymmetries in foot position during gait as well as patellofemoral instability were the outcome measures. Femoral and tibial torsion as well as morphological signs of patella maltracking (TTTG, patellar tilt and lateralisation) were measured on MRI. Results: SHV improved from 52% to 72% ( p = 0.002), WOMAC from 3 to 1 ( p < 0.001) and HHS from 68 to 86 ( p < 0.001). Hips treated for reduced FT showed better internal rotation and hips treated for excessive FT less internal rotation compared to the opposite side. 1 patient demonstrated asymptomatic minor in-toeing. Objective patellofemoral instability was not found except for in 1 patient with bilateral patellofemoral apprehension. FT was normalised (mean 16° ± 9°). Tibial torsion showed normal values. Compared to the opposite side TTTG ( p > 0.08), patellar tilt ( p > 0.09) and lateralisation ( p > 0.26) did not differ. No complications occurred. Conclusions: Subtrochanteric rotational osteotomy with hip arthroscopy improves the hip subjectively without leading to objective patellofemoral instability nor changes in the patellofemoral geometry compared to contralateral side. The technique of subtrochanteric rotational osteotomy is safe and reliable.

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Section: Discussionsupporting

confidence: 67%

Section: Methodsmentioning

confidence: 99%

Subtrochanteric rotational osteotomy for young adults with hip pain due to femoral maltorsion

2020

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“…Several techniques for quantifying torsional disorders of the tibia have been described. Although some suggest assessment using biplanar radiography or magnetic resonance imaging ( 6 ), computed tomography (CT) imaging is currently considered the gold standard ( 7 ). CT's advantages are its widespread availability, proven accuracy, short examination time, and cost-effectiveness ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

A new method for assessing tibial torsion using computerized tomography in a pediatric population

Gavira,

Cochard,

Guanziroli

et al. 2024

Front. Pediatr.

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PurposeTibial torsion disorders may lead to abnormal gait, frequently leading to a consultation with a pediatric orthopedic surgeon. The present study evaluated an alternative method for assessing tibial torsion on computerized tomography (CT) images that considers the tibial distal axis to be equivalent to the geometric axis of the tibiotalar joint.MethodsOne hundred CT scans were reviewed retrospectively, and four measurements were taken: proximal transtibial angle (PTTA), posterior margin tibial plateau angle (PMTPA), intermalleolar angle (IMA), and talar angle (TA). The tibial torsion angle was then calculated using these different angles.ResultsThe patient cohort comprised 38 girls and 62 boys, with a mean age of 12 ± 4.4 years. Median PTTA and PMTPA were −8.4° ± 14.7° and −8.8° ± 14.2°, respectively, with no statistically significant difference. Mean IMA and TA were 23° ± 16.2° and 17.2° ± 16.9°, respectively, with a statistically significant difference. Mean total measurement time per patient was 6'44", with means of 2'24" for PTTA, 36" for PMTPA, 2'14" for IMA, and 1'12" for TA.ConclusionTibial torsion values may differ significantly depending on the axis chosen to define tibial orientation. At the level of the proximal tibia, the choice of PTTA or PMTPA had little influence on the calculation of the tibial torsion angle. There was a significant difference of 5.8° when measuring the distal tibia. Measuring the PMTPA and TA is probably more suited for use in clinical practice because their tracing is simple and faster.

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Coronal and Axial Alignment: The Effects of Malalignment

Ambra

Gomoll

Farr

2019

Joint Preservation of the Knee

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The measurement of tibial torsion by magnetic resonance imaging in children: the comparison of three different methods

Cited by 6 publications

References 25 publications

Subtrochanteric rotational osteotomy for young adults with hip pain due to femoral maltorsion

Subtrochanteric rotational osteotomy for young adults with hip pain due to femoral maltorsion

A new method for assessing tibial torsion using computerized tomography in a pediatric population

Coronal and Axial Alignment: The Effects of Malalignment

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