scholarly journals Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography

Osteology ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 86-91
Author(s):  
Stuart A Aitken
Keyword(s):  
Linear Relationship ◽  
Lower Limb ◽  
Measurement Method ◽  
Full Length ◽  
Lower Limbs ◽  
Limb Length ◽  
Normative Values ◽  
Femoral Length ◽  
Tibial Length ◽  
The Mean

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.

Radiographic Assessment of Lower-Limb Discrepancy

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
Keyword(s):  
Lower Limb ◽  
Limb Length Discrepancy ◽  
Intraobserver Reliability ◽  
Reference Points ◽  
Full Length ◽  
Lower Limbs ◽  
Limb Length ◽  
Radiographic Measurement ◽  
Load Bearing ◽  
Length Discrepancy

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.

scholarly journals Prevalence and Degree of Lower Limb Inequality in Asymptomatic Young Adult Nigerians

2020 ◽  
pp. 1-9
Author(s):  
Rotimi S. Ajani ◽  
Emmanuel O. Ayanleke
Keyword(s):  
Young Adult ◽  
Ethnic Groups ◽  
Lower Limb ◽  
Full Length ◽  
Lower Limbs ◽  
Limb Length ◽  
Healthy Young Adult ◽  
Male And Female ◽  
Clinical Method ◽  
Limb Length Inequality

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.

scholarly journals Estimation of stature from percutaneous length of tibia amongst Bengali population

2019 ◽  
Vol 7 (5) ◽  
pp. 1767
Author(s):  
Tapas Ghosh ◽  
Sudipto Konar
Keyword(s):  
Lower Limb ◽  
Limb Length ◽  
Long Bones ◽  
Regression Equations ◽  
Stature Estimation ◽  
Standing Height ◽  
Tibial Length ◽  
Parametric Statistics ◽  
The Mean ◽  
High Degree

Background: Stature of an individual can be estimated from long bones as these have a direct correlation to the height of an individual. The standing height is mostly contributed lower limb length. Hence regression equations which are best upon length of lower limb long bones are indicative very much. Secular differences of tibial length could be the reason for need of more accurate equation of stature estimation among Bengali population.Methods: In this present study the maximum percutaneous tibial length and the corresponding standing height of adult 260 male and 210 female Bengali subjects were taken. The data were analyzed by parametric statistics and the regression equations were derived.Results: The mean standing height of subjects was 159.15 cm in males and 157.12 cm. in females. It was determined that percutaneous tibial length and stature were positively correlated; the formulated regression equations were seen to be statistically significant (p <0.05) in both the sexes.Conclusions: The present study revealed that there is high degree of correlation between percutaneous tibial length and standing height of Bengali subjects. Hence applicability of the present equations is critically discussed as these will be very much useful for various practical aspects.

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):  
Lower Limb ◽  
Full Length ◽  
Limb Length

The Effects of Uni- and Bilateral Fatigue on Postural and Power Tasks

2013 ◽  
Vol 29 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Paulo H. Marchetti ◽  
Maria I.V. Orselli ◽  
Marcos Duarte
Keyword(s):  
Lower Limb ◽  
Healthy Subjects ◽  
Postural Sway ◽  
Center Of Pressure ◽  
Lower Limbs ◽  
Quiet Standing ◽  
Ground Reaction Forces ◽  
Before And After ◽  
Reaction Forces ◽  
The Mean

The aim of this study was to investigate the effects of unilateral and bilateral fatigue on both postural and power bipedal tasks. Ten healthy subjects performed two tasks: bipedal quiet standing and a maximal bipedal counter-movement jumping before and after unilateral (with either the dominant or nondominant lower limb) and bilateral (with both lower limbs) fatigue. We employed two force plates (one under each lower limb) to measure the ground reaction forces and center of pressure produced by subjects during the tasks. To quantify the postural sway during quiet standing, we calculated the resultant center of pressure (COP) speed and COP area of sway, as well as the mean weight distribution between lower limbs. To quantify the performance during the countermovement jumping, we calculated the jump height and the peak force of each lower limb. We observed that both unilateral and bilateral fatigue affected the performance of maximal voluntary jumping and standing tasks and that the effects of unilateral and bilateral fatigue were stronger in the dominant limb than in the nondominant limb during bipedal tasks. We conclude that unilateral neuromuscular fatigue affects both postural and power tasks negatively.

scholarly journals Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Orlando Adas Saliba Júnior ◽  
Mariangela Giannini ◽  
Ana Paula Mórbio ◽  
Orlando Saliba ◽  
Hamilton Almeida Rollo
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Varicose Vein Surgery ◽  
Postoperative Evaluation ◽  
Perforating Veins ◽  
Primary Varicose Veins ◽  
Ceap Classification ◽  
The Mean ◽  
Deep Vein

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM).Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM.Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P<0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins.Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

scholarly journals TL 18165 - Relationship between lower limb dysmetria and plantar fasciitis

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 96S
Author(s):  
Henrique Mansur ◽  
Guilherme Gonçalves Feijó Carvalho ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Lower Limb ◽  
Plantar Fasciitis ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Calcaneal Spur ◽  
The Mean ◽  
The Relationship

Introduction: Plantar fasciitis is an inflammatory process of multifactorial etiology that affects the origin of the plantar fascia and surrounding structures. A difference in length between lower limbs is relatively common within the population and can sometimes cause changes in biomechanics and symptoms. The objective of this study is to evaluate the relationship between lower limb dysmetria and plantar fasciitis. Methods: A cross-sectional study was performed to measure the length of the lower limbs by scanometry in patients diagnosed with plantar fasciitis. Other risk factors, such as body mass index, foot shape and the presence of plantar calcaneal spur, were also assessed in foot radiographs. Results: Of the 54 patients included in the study, 44.4% were men, and the mean age was 50.38 (23-73 years); 81.5% had pain in one foot, and 53.7% had feet that were considered plantigrade. We observed dysmetria in 88.9% of the sample, with a mean of 0.749 cm (SD ±0.63). In addition, 46.3% feet with pain showed calcaneal spurs on the radiographs. Conclusion: Approximately 90% of patients showed lower-limb dysmetria and, in most cases, the side with the shorter limb was affected by plantar fasciitis

scholarly journals Regression Equation and Multiplication Factor for the Reconstruction of Stature by Femur Length

2020 ◽  
Vol 8 (02) ◽  
pp. 25-30
Author(s):  
Raj Kumar Karki ◽  
Pankaj Kumar Singh ◽  
Abdul Sami Khan ◽  
Sudeep Regmi
Keyword(s):  
Statistical Analysis ◽  
Direct Relationship ◽  
Regression Equation ◽  
Lower Limbs ◽  
Measuring Instruments ◽  
Multiplication Factor ◽  
Femur Length ◽  
Femoral Length ◽  
Standard Position ◽  
The Mean

INTRODUCTION Stature is the important parameter along with age, sex and race while identifying bodies. Stature has direct relationship with the skeletal dimensions most importantly with lower limbs. This study attempts to derive regression equation (RE) and multiplication factor (MF) from femur length (FL) which could be used for stature reconstruction. MATERIAL AND METHODS The study was conducted amongst the 160 students and staff of Dhulikhel Hospital, Nepal for the period of six months from February 2020 to July 2020. The sample was composed of 95 males and 65 females between the age of 18 - 40 years. The femoral length and height was measured in standard position using standard measuring instruments. Statistical analysis was done using SPSS 25.   RESULTS The mean height and femur length of overall sample was 162.33 ±7.62 cm and 40.14 ±2.132 cm respectively, male surpassing the female dimensions. There was a strong correlation between femur length and stature (r = 0.723, 0.869 and 0.791 for males, females, and overall participants respectively). MF was derived as 4.084 ±0.139, 3.99 ±0.11, 4.047 ±0.135 and RE was derived as y = 75.51 + 2.13*FL ±4.06, y = 55.238 + 2.581*FL ±2.999, y = 48.791 + 2.829*FL ±4.672 for males, females and overall participants. Both methods were checked for accuracy and could successfully interpret the height (p>0.05). CONCLUSION The femoral length was found to be a reliable estimator of stature of an individual by using both RE and MF.

scholarly journals A Novel Tool for Quantitative Assessment of Lower Limb Proprioception: Demonstration with Young Adults, Elderly and Stroke Survivors

2021 ◽  
Author(s):  
Asya Mikhaylov ◽  
Yogev Koren ◽  
Simona Bar-Haim ◽  
Ilana Nisky
Keyword(s):  
Young Adults ◽  
Lower Limb ◽  
Quantitative Assessment ◽  
Spatial Information ◽  
Tracking System ◽  
Task Type ◽  
Lower Limbs ◽  
Stroke Survivors ◽  
Assessment Protocol ◽  
The Mean

Abstract BackgroundStroke and ageing are common causes for proprioceptive impairments. Such impairments may contribute to disabilities in daily living activities, such as walking. Yet, current rehabilitation methods mainly focus on motor disabilities, and often neglect somatosensory impairments. Moreover, clinical methods for proprioception assessment of both the upper and lower limb are subjective and suffer from inconsistency between evaluators, and the majority of the research in quantitative assessment of proprioception focuses on the upper limb. To address these gaps, we present a novel tool for quantitative assessment of proprioception of the lower limb.MethodsWe developed a tool that consists of a magnetic tracking system with magnetic sensors placed on the participants’ toes while the participants were laying on their side. We designed an assessment protocol that includes contralateral position matching tests and ipsilateral position matching tests, and applied them to both lower limbs (N: non-dominant and D: dominant). We validated the tool on three groups of participants: young adults (n=18), elderly (n=8), and stroke survivors (n=5) by comparing the results of the mean absolute error (MAE), bias and the mean variable error (MVE).ResultsWe evaluated the effect of group type, proprioceptive input, task type and their interactions. We compared between young adults and elderly with statistical analysis, and demonstrated the results of the stroke survivors. We found significant differences in MAE and bias between the elderly and young adults in the contralateral tasks, particularly once spatial information is transmitted from the N limb to the D limb, indicating that the ability to transit spatial information contralaterally becomes more challenging with age. The bias also indicated that the contralateral task is more challenging with the groups, independently. ConclusionsUsing contralateral position matching may be an effective way to identify potential somatosensory impairments. In order to avoid a long and unnecessary assessment, we suggested using contralateral position matching as a screening phase in identifying lower limb proprioceptive impairments, followed by ipsilateral position matching only for individuals with impaired results for identifying possible confounds from motor and cognitive impairments.

scholarly journals Lower limb lengthening over an intramedullary nail: a long-term follow-up study of 28 cases

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Pasquale Farsetti ◽  
Fernando De Maio ◽  
Vito Potenza ◽  
Kristian Efremov ◽  
Martina Marsiolo ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Intramedullary Nail ◽  
Lower Limb ◽  
Average Length ◽  
Limb Lengthening ◽  
Limb Length ◽  
Tibial Lengthening ◽  
The Mean

Abstract Background Limb lengthening using an external fixator requires a long period of external fixation and may be associated with several complications such as axial deformity, fracture of the regenerated bone, and joint stiffness. With the goal of reducing the time of external fixation as well as some of these complications, we performed femoral or tibial lengthening over an intramedullary nail, according to Paley’s technique, in 28 patients, followed up after a mean period of 8 years. Materials and methods Twenty-eight patients treated for lower limb discrepancy by limb lengthening over an intramedullary nail were reviewed from 5 to 11 years after healing of regenerated bone. There were 20 femurs and 8 tibiae, with average age at surgery of 14.2 years and average length inequality of 6.1 cm for femurs and 5.3 cm for tibiae. Results The mean lengthening was 5.8 cm for femurs and 4.8 cm for tibiae. The mean period of radiographic consolidation of the regenerated bone was 6 months for femoral lengthening and 4.5 months for tibial lengthening. At follow-up, we observed 8 excellent results, 15 good results, 4 fair results, and 1 poor result, based on Paley’s evaluation criteria. The main complications were one deep infection, one nonunion of the distracted segment, one breakage of the distal fiche of the external fixator, and one breakage of both distal locking screws of the intramedullary nail. Discussion We believe that limb lengthening over an intramedullary nail still represents a good method to treat limb length discrepancy because it reduces the time of external fixation, prevents axial deformities and fractures of regenerated bone, and allows early rehabilitation. The new intramedullary lengthening nails, which theoretically are the ideal device for treating limb length inequality, are still very expensive and need longer follow-up for definitive evaluation. Level of evidence 4.

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