Assessment of Lower Limb Length and Alignment by Biplanar Linear Radiography: Comparison With Supine CT and Upright Full-Length Radiography

2014 ◽  
Vol 202 (2) ◽  
pp. W161-W167 ◽  
Author(s):  
Roman Guggenberger ◽  
Christian W. A. Pfirrmann ◽  
Peter P. Koch ◽  
Florian M. Buck
Keyword(s):  
Osteology ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 86-91
Author(s):  
Stuart A Aitken

Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the corresponding femorotibial ratio. The PACS-based length measurement method used in this study displayed excellent inter-observer reliability (ICC of 0.99). This study presents a normal range of values for lower limb length in adults and is the first to identify a linear relationship between tibial length and the femorotibial ratio.


2017 ◽  
Vol 107 (5) ◽  
pp. 393-398
Author(s):  
Maria Reina-Bueno ◽  
Guillermo Lafuente-Sotillos ◽  
Jose M. Castillo-Lopez ◽  
Estela Gomez-Aguilar ◽  
Pedro V. Munuera-Martinez

Background: This study compares different lower-limb length measurements using tests of lower-limb upright full-length radiography and anteroposterior radiography of load-bearing hips. Methods: Forty-seven consecutive individuals aged 17 to 61 years (mean ± SD, 31.47 ± 11.42 years) voluntarily took part in the study; 23 (48.9%) were women and 24 (51.1%) were men. All individuals presenting a difference of 5 mm or greater between both lower limbs quantified with a tape measure were included. All of the participants signed an informed consent form to take part in the study. Two anteroposterior load-bearing radiographs were taken: one of the hip and an upright full-length radiograph of the lower limbs. Lower-limb–length discrepancy was quantified by taking different reference points. Interobserver and intraobserver reliability was assessed for each radiographic measurement. Any correlation between the different measurements were also verified. Results: Interobserver and intraobserver reliability was high for all of the measurements because the intraclass correlation was greater than 0.75 in all of the cases. There was a strong and positive correlation between the different measurements because when performing bivariate correlations with the Pearson correlation coefficient, positive values close to 1 were found. Conclusions: In this study, the different reference points reported in the upright full-length radiograph in addition to the hip radiographs are useful for assessing lower-limb–length discrepancy. The results showed that there is a correct correlation between the different measurements.


Author(s):  
Rotimi S. Ajani ◽  
Emmanuel O. Ayanleke

Objective: The development of right and left lower limbs start at the same time and subsequent serial growth occurs simultaneously however at adulthood, small but usually functionally negligible differences exist in their lengths. This study set out to find out the prevalence and degree of lower limb length inequality (LLI) amongst young adult Nigerians with grossly normal lower limbs. Methods: Full length and segmental lengths of one hundred and three healthy young adult Nigerians of different ethnic groups were measured using the direct clinical method. Results: The overall prevalence of LLI was 89.3% while the rate for male and female was 96.2% and 82.4% respectively. The LLI range was 0.5 - 2.5 cm with majority being less than 2.0 cm. The LLI was significantly higher in male (1.18 ± 0.83 vs 0.75±0.60 cm). Side for side, the male limb is significantly longer than that of the female. The thigh girth was significantly wider in the female while there was no difference in the leg girth between male and female. The males were found to be significantly taller than the females. Inter-ethnic comparison of the various parameters did not reveal any significance difference. Conclusion: Anatomical lower limb inequality is very common amongst young adult Nigerians without any gross musculoskeletal but it is not obvious.


2021 ◽  
Author(s):  
Neil Robert Caton ◽  
David M. G. Lewis

Numerous taxa have evolved physiological appendage-based weaponry to increase damage output in violent fights, but no research has empirically shown that Homo sapiens upper appendages have uniquely evolved to increase resource-provisioning potential in real-world combat. In Study 1, we used actual fight outcome data (N = 715 fighters) to examine multiple competing hypotheses—the striker, defender, grappler, and knockout hypotheses—for the evolution of Homo sapiens upper limb length, controlling for approximately a dozen confounding variables (e.g., biacromial width, lower limb length, age, weight, height). There was exclusive support for the knockout hypothesis: upper limb length increases fighting success through knockout power. There was also evidence for a real-world association between biacromial width and knockout power. Because sexual dimorphism often emerges from selection on morphological structures that improve male’s fighting success, we consequently expected sexual dimorphism in upper limb length. Studies 2a-2d provided powerful evidence for this new universal sexual dimorphism in upper limb length. Even after controlling for weight, height, and lower limb length, males exhibited longer upper limbs than females across the globe: from mixed-martial-artists (Study 2a) and Croatian adolescents (but not pre-pubertal children; Study 2b) to older Singaporean adults (Study 2c) and over 6,000 United States Army personnel (Study 2d) born across seven major world regions (Africa, Europe, Asia, Oceania, and North, Central, and South America). Combined, our results provide comprehensive support for the argument that intrasexual selection has uniquely shaped Homo sapiens upper limb length to enhance fighting performance in real-world combat.


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