scholarly journals The Profile and Development of the Lower Limb in Setswana-Speaking Children between the Ages of 2 and 9 Years

2020 ◽  
Vol 17 (9) ◽  
pp. 3245
Author(s):  
Mariaan van Aswegen ◽  
Stanisław H. Czyż ◽  
Sarah J. Moss
Keyword(s):  
South African ◽  
Lower Limb ◽  
Limb Development ◽  
Tibial Torsion ◽  
Profile Data ◽  
Anteversion Angle ◽  
Torsion Angles ◽  
Tibiofemoral Angle ◽  
Nigerian Children ◽  
Intermalleolar Distance

Profile data on normal lower limb development and specifically tibiofemoral angle development in black, Setswana-speaking South African children are lacking. This study aimed to provide profiles on the development of the tibiofemoral angle, hip anteversion angle and tibial torsion angles in two- to nine-year-old children. Measurements of the tibiofemoral angle, intercondylar distances or intermalleolar distances, quadriceps-angle, hip anteversion- and tibial torsion angle were clinically obtained from 691 healthy two- to nine-year-old children. Two-year-old children presented with closest to genu varum at −3.4° (±3.4°). At three years, a peak of −5.7° (±2.3°) genu valgum was seen, which plateaued at −4.5° (±2.1°) at age nine years. Intermalleolar distance results support tibiofemoral angle observations. Small quadricep-angles were observed in the two-year-old group, (−3.81° ± 3.77°), which increased to a mean peak of −9.2° (±4.4°) in nine-year-olds. From the age of four years old, children presented with neutral tibial torsion angles, whilst two- and three-year-olds presented with internal tibial torsion angles. Anteversion angles were the greatest in three-year-olds at 77.6° ± 13.8° and decreased to a mean angle of 70.8° ± 6.9° in nine-year-olds. The tibiofemoral angle developed similarly to those tested in European, Asian and Nigerian children, but anteversion- and internal tibial torsion angles were greater in the Setswana population than angles reported in European children. Our findings indicate that lower limb development differs in different environments and traditions of back-carrying may influence the development, which requires further investigation.

scholarly journals Development of the tibiofemoral angle in a cohort of Nigerian children during the first 3 years of life

2013 ◽  
Vol 7 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Olufemi O. Oyewole ◽  
Aderonke O. Akinpelu ◽  
Adesola C. Odole
Keyword(s):  
Tibiofemoral Angle ◽  
Nigerian Children

scholarly journals Genu valgum deformity – correction by a wedgeless implantless femoral “V” osteotomy

2021 ◽  
Vol 87 (2) ◽  
pp. 247-254
Author(s):  
Amrit Goyal ◽  
Vikas Gupta ◽  
Meenakshi Goyal ◽  
Rajesh Chandra ◽  
Vinod K Sharma
Keyword(s):  
Internal Fixation ◽  
Mechanical Axis ◽  
Deformity Correction ◽  
Image Intensifier ◽  
Valgus Knee ◽  
Axis Deviation ◽  
Mechanical Axis Deviation ◽  
Tibiofemoral Angle ◽  
Average Value ◽  
Intermalleolar Distance

Coronal malalignment of the knee joint is very common in developing countries especially because of nutritional rickets. Significant valgus deformity needs to be treated surgically to improve appearance, gait and function of the patient. The purpose of this prospective study was to evaluate the results of supracondylar “V” osteotomy as a surgical technique for correction of the valgus knee deformity. This study was conducted in a tertiary level teaching hospital and 30 cases were included in the study. For all the patients deformity was assessed using ana- tomical tibiofemoral angle, mechanical axis deviation and intermalleolar distance preoperatively and post- operatively. The average age of our patients was 13.7 years and the average follow up was3.29 years (1.39-14.22 yrs). Clinically the average value of intermalleolar distance preoperatively was 16cm and 3.2 cm postperatively. Average pre-operative tibiofemoral angle was 23° and the average postoperative angle was 6 0 which was found to be statistically significant using the Paired t test (p<0.005). The average value of preoperative mechanical axis deviation was 3.1 cm which decreased to an average value of 1.1 cm postoperatively. The results with this technique have been encouraging. The advantages of this technique are low morbidity, good stability allowing early ambulation, ability to adjust alignment postoperatively by casting and no need for internal fixation. Few studies have been conducted on osteotomies that do not require internal fixation and are inherently stable. This technique has the advantage of practically no occurrence of any infection or a second surgery to remove hardware in children and adolescents. Since no specialized instrumentation, image intensifier and implants are required, it is cost effective and can be used in any primary care or district level surgical setup in a developing country like ours.

scholarly journals Updated lower limb stature estimation equations for a South African population group

2020 ◽  
Vol 116 (5/6) ◽  
Author(s):  
Mubarak A. Bidmos ◽  
Desiré Brits
Keyword(s):  
South African ◽  
Standard Error ◽  
Lower Limb ◽  
Population Group ◽  
African Population ◽  
Regression Equations ◽  
South African Population ◽  
Stature Estimation ◽  
Limb Bones ◽  
Black South African

One of the main steps in the identification of an unknown person, from their skeletal remains, is the estimation of stature. Measurements of intact long bones of the upper and lower extremities are widely used for this purpose because of the high correlation that exists between these bones and stature. In 1987, Lundy and Feldesman presented regression equations for stature estimation for the black South African population group based on measurements of bones from the Raymond A. Dart Collection of Human Skeletons. Local anthropologists have questioned the validity of these equations. Living stature measurement and magnetic resonance imaging scanograms of 58 adult volunteers (28 males and 30 females) representing the modern black South African population group were obtained. Physiological length of the femur (FEPL) and physiological length of the tibia (TPL) were measured on each scanogram and substituted into appropriate equations of Lundy and Feldesman (S Afr J Sci. 1987;83:54–55) to obtain total skeletal height (TSHL&F). Measured total skeletal height (TSHMeas) for each subject from scanograms was compared with TSHL&F. Both FEPL and TPL presented with significantly high positive correlations with TSHMeas. A comparison between TSHL&F and TSHMeas using a paired t-test, showed a statistically significant difference – an indication of non-validity of Lundy and Feldesman’s equations. New regression equations for estimation of living stature were formulated separately for male and female subjects. The standard error of estimate was low, which compared well with those reported for other studies that used long limb bones. Significance: • Statistically significant differences were observed between measured and estimated skeletal height, thus confirming non-validity of Lundy and Fieldsman’s (1987) equations for lower limb bones. • New regression equations for living stature estimation were formulated for femur and tibia lengths, and the low standard error of estimates of equations compared well to results from other studies.

Ginocchio valgo punto per punto: quello che deve sapere il pediatra

2021 ◽  
Vol 40 (5) ◽  
pp. 303-307
Author(s):  
Maria Rita L. Genovese ◽  
Francesca Vittoria ◽  
Raffaele Grasso ◽  
Egidio Barbi ◽  
Marco Carbone
Keyword(s):  
Standard Treatment ◽  
Invasive Procedure ◽  
Spontaneous Resolution ◽  
Knee Valgus ◽  
Minimally Invasive Procedure ◽  
Tibiofemoral Angle ◽  
Know How ◽  
Intermalleolar Distance ◽  
Paediatric Orthopaedic ◽  
Residual Growth

Knee valgus is one of the most frequent paediatric orthopaedic problems based on the evaluation by the paediatricians. Most cases are physiological variants that resolve spontaneously with growth, however pathological cases require surgical treatment. Therefore, the paediatrician must know how to distinguish between the two entities from the beginning, sending the child to the specialist when necessary, thus respecting the correct timing for treatment. The most frequent condition is idiopathic knee valgus, which occurs when the physiological variant persists after the age of 8 without spontaneous resolution. Children who always need specialist evaluation are those who on physical examination show a tibiofemoral angle greater than 15° with an intermalleolar distance of about 10 cm that persists beyond 10 years of age. The gold standard treatment in these children is growth-guided hemiepiphysiodesis, namely a simple and minimally invasive procedure that reshapes the altered angle of the knees through the application of the 8-plate. The correction is based on the presence of residual growth of the physical cartilages, therefore it should not be performed too late, but not before 10 years of age.

Missing Midline Metatarsals Conform to Plantar Arterial Arch Dysgenesis

2020 ◽  
Vol 110 (3) ◽  
Author(s):  
David R. Hootnick
Keyword(s):  
Risk Factor ◽  
Lower Extremity ◽  
Lower Limb ◽  
Limb Development ◽  
Long Bone ◽  
Long Bones ◽  
Adult Pattern ◽  
Embryonic Limb ◽  
A Current ◽  
Embryonic Vessels

Midline metatarsal ray deficiencies, which occur in approximately half of congenital short limbs with fibular deficiency, provide the most distal and compelling manifestation of a fluid spectrum of human lower-extremity congenital long bone reductions; this spectrum syndromically affects the long bone triad of the proximal femur, fibula, and midline metatarsals. The bony deficiencies correspond to sites of rapid embryonic arterial transitioning. Long bones first begin to ossify because of vascular invasions of their respective mesenchymal/cartilage anlagen, proceeding in a proximal-to-distal sequence along the forming embryonic limb. A single-axis artery forms initially in the embryonic lower limb by means of vasculogenesis. Additional arteries evolve in overlapping transitional waves, in proximity to the various anlagen, during the sixth and seventh weeks after fertilization. An adult pattern of vessels presents by the eighth week. Arterial alterations, in the form of retained primitive embryonic vessels and/or reduced absent adult vessels, have been observed clinically at the aforementioned locations where skeletal reductions occur. Persistence of primitive vessels in association with the triad of long bone reductions allows a heuristic estimation of the time, place, and nature of such coupled vascular and bony dysgeneses. Arterial dysgenesis is postulated to have occurred when the developing arterial and skeletal structures were concurrently vulnerable to teratogenic insults because of embryonic arterial instability, a risk factor during arterial transition. It is herein hypothesized that flawed arterial transitions subject the prefigured long bone cartilage models of the rapidly growing limb to the risk of teratogenesis at one or more of the then most rapidly growing sites. Midline metatarsal deficiency forms the keystone of this developmental concept of an error of limb development, which occurs as a consequence of failed completion of the medial portion of the plantar arch. Therefore, the historical nomenclature of congenital long bone deficiencies will benefit from modification from a current reliance on empirical physical taxonomies to a developmental foundation.

Realization of a prosthesis of the lower limb: Development of kinematics

1991 ◽  
Vol 8 (3) ◽  
pp. 137-142 ◽  
Author(s):  
Alberto Rovetta ◽  
Xia Wen ◽  
Francesca Cosmi
Keyword(s):  
Lower Limb ◽  
Limb Development

scholarly journals Dependency of Lower Limb Joint Reaction Forces on Femoral Anteversion

2021 ◽  
Author(s):  
Luca Modenese ◽  
Martina Barzan ◽  
Christopher P Carty
Keyword(s):  
Body Weight ◽  
Knee Joint ◽  
Lower Limb ◽  
Femoral Anteversion ◽  
Accurate Estimation ◽  
Grand Challenge ◽  
Anteversion Angle ◽  
Joint Reaction Forces ◽  
Reaction Forces ◽  
Joint Reaction

AbstractBackgroundMusculoskeletal (MSK) models based on literature data are meant to represent a generic anatomy and are a popular tool employed by biomechanists to estimate the internal loads occurring in the lower limb joints, such as joint reaction forces (JRFs). However, since these models are normally just linearly scaled to an individual’s anthropometry, it is unclear how their estimations would be affected by the personalization of key features of the MSK anatomy, one of which is the femoral anteversion angle.Research QuestionHow are the lower limb JRF magnitudes computed through a generic MSK model affected by changes in the femoral anteversion?MethodsWe developed a bone-deformation tool in MATLAB (https://simtk.org/projects/bone_deformity) and used it to create a set of seven OpenSim models spanning from 2° femoral retroversion to 40° anteversion. We used these models to simulate the gait of an elderly individual with an instrumented prosthesis implanted at their knee joint (5th Grand Challenge dataset) and quantified both the changes in JRFs magnitude due to varying the skeletal anatomy and their accuracy against the correspondent in vivo measurements at the knee joint.ResultsHip and knee JRF magnitudes were affected by the femoral anteversion with variations from the unmodified generic model up to 11.7±5.5% at the hip and 42.6±31.0% at the knee joint. The ankle joint was unaffected by the femoral geometry. The MSK models providing the most accurate knee JRFs (root mean squared error: 0.370±0.069 body weight, coefficient of determination: 0.764±0.104, largest peak error: 0.36±0.16 body weight) were those with the femoral anteversion angle closer to that measured on the segmented bone of the individual.SignificanceFemoral anteversion substantially affects hip and knee JRFs estimated with generic MSK models, suggesting that personalizing key MSK anatomical features might be necessary for accurate estimation of JRFs with these models.

Extent of Duplication in Lower-Limb Malformations Suggests the Time of the Teratogenic Insult

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 411-413
Author(s):  
David S. Packard ◽  
E. Mark Levinsohn ◽  
David R. Hootnick
Keyword(s):  
Lower Limb ◽  
Limb Development ◽  
Lower Limbs ◽  
Relative Time ◽  
Vertebrate Limb ◽  
The Future ◽  
Vertebrate Limb Development ◽  
Limb Malformations ◽  
Human Limb ◽  
Limb Specification

Investigations of vertebrate limb development have suggested that a process called "specification" instructs the cells of the future limb as to which tissues they should form. This process proceeds in a wave-like manner, starting at the most proximal levels of the future limb and ending at its distal tip. Human limb specification probably occurs during the fourth and fifth weeks of development. It is proposed that human limb duplications result from errors of specification and, furthermore, that the more distal the duplication, the later the occurrence of the teratogenic event during the specification process. Therefore, among human lower limbs with duplications, one may be able to estimate the relative time of the teratogenic event by comparing the levels at which the duplications occur.

scholarly journals Guided Growth Vs. Tibial Osteotomy in Early Stage of Blount Disease

2021 ◽  
Author(s):  
Beaudelaire Romulus ASSAN ◽  
Anne-Laure SIMON ◽  
Sonia ADJADOHOUN ◽  
Geraud Garcia Philemon Satingo SEGBEDJI ◽  
Cedric Bignon Ulrich ASSOUTO ◽  
...  
Keyword(s):  
Analytical Study ◽  
Mechanical Axis ◽  
Early Stage ◽  
Tibial Osteotomy ◽  
Tibial Torsion ◽  
Guided Growth ◽  
Tibiofemoral Angle ◽  
Blount Disease ◽  
Radiological Stage

Abstract Background: There are no real comparative study between guided growth and tibial osteotomy in early stage of Blount disease. The aim of this work was to compare the results of patients treated by these two techniques. Method: We had performed a multicenter retrospective, descriptive and analytical study over a period of 05 years. All children admitted for Blount disease without medial proximal tibial epiphysiodesis and treated by one of these techniques were included. Age, sex, existence of tibial torsion, radiological stage based on Catonne's classification were studied. We also evaluated preoperatively, immediately postoperatively, and at latest follow-up tibiofemoral angle, mechanical medial proximal tibial angle, mechanical lateral distal femoral angle, and the tibial metaphyso-diaphyseal angle. Results: Seventeen (17) patients for 24 knees were included. The sex ratio was 0.54. All patients had tibial torsion. Fourteen knees (64%) were treated by guided growth at a mean age of 5.5±2.5 (range, 3-9 years). With a mean follow-up of 12 ± 3.5 months (range 6-15month); tibiofemoral, mechanical medial proximal tibial, and tibial metaphyso-diaphyseal angles were significantly corrected with normalization of the mechanical axis in 8 patients (60%). Ten patients (36%) were treated by revisited Rab osteotomy at a mean age of 7.7±4.9 years (range, 4-12 years). At a mean follow-up of 23±15 months (range, 10-48 months), only tibial metaphyso-diaphyseal angle was significantly corrected. The recurrence rate was 60%. Despite perfect correction of tibiofemoral, and mechanical medial proximal tibial angles in immediate postoperative follow-up, they gradually decrease in patients treated by Rab osteotomy, whereas they gradually increased in case of guided growth. Conclusion: Guided growth appears to be the best treatment for early stage of Blount disease. Trial registration: Retrospectively registered

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