Radiographic Assessment of Lower Limb Alignment in South African Children

• Published in: Journal of limb lengthening & reconstruction Vol. 9; no. 1; pp. 35 - 40
• Main Authors: Foxcroft, William Donnavan, du Toit, Jacques, Ferreira, Nando, Thiart, Mari, Saini, Aaron, Burger, Marilize
• Format: Journal Article
• Language: English
• Published: 01.01.2023
• ISSN: 2455-3719; 2455-3719
• DOI: 10.4103/jllr.jllr_1_23

Context: Radiographic measurements on full-length lower limb views are the standard for lower limb deformity analysis. The published measurements of Paley et al . [1] on lower limb alignment are the gold standard, but were derived from small adult samples. There are no radiographic measurements reported exclusively of South African children. Aims: The study aimed to establish the normal values of lower limb alignment and joint orientation angles in South African children between 5 and 18 years old, at specific age intervals and to compare these measurements to the values as derived from Paley et al . [1] Settings and Design: A cross-sectional radiographic study including all 5–18-year-old children who underwent full-length anteroposterior radiographs between 2012 and 2020 was conducted. Subjects and Methods: Radiographic measurements were done as described by Paley. Differences in measurements obtained and those reported by Paley et al . [1] were compared. Results: A total of 190 patients (110 male; 80 female) with a mean age of 10.0 ± 3.3 years were included. The medial neck-shaft angle (MNSA), mechanical and anatomical lateral distal femoral angle (LDFA) and lateral distal tibia angle (LDTA) remained consistent throughout the age groups. Significant differences between Paley’s published values and our cohort were observed for the median mechanical axis deviation (MAD), MNSA and medial proximal tibia angle(MPTA). [1] Conclusion: Significant differences were seen in the mean/median of our MAD, MNSA, and MPTA compared to Paley’s work. Other measured values are comparable with previously published adult and pediatric populations. Using the acquired data, we were able to develop set values that could be the norm for pediatric joint orientation angles in the South African population.