Lower Limb Alignment in Indian Children: A Radiographic Analysis of Coronal Plane Parameters

Area of Science:

• Orthopedics
• Pediatric Radiology
• Biomechanical Analysis

Background:

• Tibiofemoral angle variations exist in Indian children compared to other ethnicities.
• No prior studies have detailed coronal plane radiographic angles in this population.
• Understanding these variations is crucial for accurate diagnosis and treatment.

Purpose of the Study:

• To evaluate coronal plane alignment in Indian children.
• To establish normative radiographic values for the tibiofemoral angle in Indian pediatric population.
• To compare these values with international standards.

Main Methods:

• Retrospective analysis of 221 full-length standing radiographs of Indian children (<16 years) from 2011-2019.
• Inclusion criteria: unilateral congenital, post-traumatic, or post-infective lower limb deformity.
• Radiographic measurements included mLDFA, MPTA, TFA, HKA, MAD, and mLPFA.

Main Results:

• Analysis of 177 children (103 boys, 74 girls; mean age 8y 6m).
• Mean mLDFA stabilized around 87-88° after age 5. Mean MPTA stabilized around 88° after age 8.
• Adult tibiofemoral angle (TFA) values were achieved after 8 years; mLDFA, MPTA, mLPFA predicted TFA changes.

Conclusions:

• Tibiofemoral angle development in Indian children shows ethnic-specific patterns.
• Age-specific normative data is essential for Indian children under 8 years.
• These findings aid in precise orthopedic assessments and interventions in pediatric patients.