The Hip-Knee-Ankle Angle in Children: Reference Values Based on a Full-Length Standing Radiograph

• DOI: 10.2106/jbjs.i.00015
• Publication Date: 2009-10-01T17:28:32Z
• Authors: Sanjeev Sabharwal; Caixia Zhao
• Keywords: Epiphysis

Background: It is well recognized that the alignment of lower limb changes during early childhood. The hip-knee-ankle angle often referred to as mechanical femoral-tibial and measured on a full-length radiograph extremity. While several authors have independently reported consistent reference values for in adults, such not been documented children. purpose our study was establish assess relationship between it anatomic Methods: A database at single institution searched patients who were one less than eighteen years old time standing extremities made. Radiographs uninvolved extremity (the without any radiographic abnormalities or clinical concerns) analyzed. line connecting center ossified femoral head distal epiphysis another talar dome measured. Simple regression analyses performed determine this angle. Results: total 354 unaffected 253 children mean +3.6° (varus) two −2.5° (valgus) those three old. After age seven years, value +0.3° (varus), which within 1° available adult population (mean, +1.2° [varus]). There linear angles (r = 0.87, p < 0.0001). Despite varying different ages, absolute difference remained relatively constant 6.7°) associated with changing −0.09). Conclusions: In sample, older approached adults North America. Although younger distinct from population, angular measurements essentially unaffected. use age-specific both recommended