Radiolographic assessment of lower limb alignment in South African children

dc.contributor.advisorDu Toit, Jacquesen_ZA
dc.contributor.advisorBurger, Marilize Cornelleen_ZA
dc.contributor.advisorFerreira, Nandoen_ZA
dc.contributor.authorFoxcroft, William Donnavanen_ZA
dc.contributor.otherFaculty of Medicine and Health Sciences. Dept. of Surgical Sciences. Orthopaedic Surgery.en_ZA
dc.date.accessioned2022-07-06T09:40:25Zen_ZA
dc.date.accessioned2023-01-16T12:40:12Zen_ZA
dc.date.available2022-07-06T09:40:25Zen_ZA
dc.date.available2023-01-16T12:40:12Zen_ZA
dc.date.issued2022-07en_ZA
dc.descriptionThesis (MMed) -- Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH ABSTRACT: Background: Radiographic measurements on full length standing lower limb views are the standard for lower limb deformity analysis. Published measurements of Paley et al. on lower limb alignment is the gold standard but was derived from small adult samples. There are no radiographic measurements reported exclusively of children of South African descent. The study aimed to establish 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. Methods: A cross-sectional radiographic study including all 5-18 year old children who underwent full-length anteroposterior radiographs between 2012 and 2020 was conducted. Radiographic measurements were done as described by Paley. Differences in measurements obtained and those reported by Paley et al.1 were investigated using a T-test for a single mean against a reference constant, using an alpha level of 0.05. 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). The median MAD across age groups was -2.2 mm (IQR -6.4 – 1.5) with all subgroups showing a lateral MAD (valgus alignment), compared to the median MAD of +9.7mm (varus alignment) from Paley et al.1 The MNSA had a mean of 135.7°, compared to 129.7° from Paley. The mean MPTA was 89.7°, compared to Paley’s 87.2°. The MPTA had minimal change throughout the age groups. Conclusion: Significant differences were seen in the mean/median of our MAD, MNSA and MPTA compared to Paley’s work. Our MAD have a sustained valgus tibio-femoral angulation throughout our population. Our MNSA have more pronounced valgus with minimal change throughout growth. The increasing MPTA leads to a more valgus joint line when compared to other studies. Other measured values are comparable with previously published adult and paediatric populations. We were able to develop set values that could be the norm for paediatric joint orientation angles in the South African population.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.af_ZA
dc.description.versionMastersen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125894en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectAbnormalities, Human -- South Africaen_ZA
dc.subjectRadiography, Medical -- Positioning -- South Africaen_ZA
dc.subjectAbnormalities, Human -- South Africaen_ZA
dc.subjectUCTDen_ZA
dc.titleRadiolographic assessment of lower limb alignment in South African childrenen_ZA
dc.typeMastersen_ZA
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