Growth pattern of genu varum and valgum in Indian tribal children of Jharkhand state

Abstract               Background: Genu varum- valgum can be determined by measuring tibiofemoral angle (TFA), intercondylar distance (ICD) and intermalleolar distance (IMD). Current study establishes the reference values of TFA (degrees) in normal healthy tribal population of Ranchi district. Previous studies have noted the regional differences in TFA. Despite its clinical importance and social relevance, literature is scanty in Indian population especially in northern India tribal children. Material and Methods: A cross sectional study is performed to assess the knee angle. 360 tribal children aged between 2-14 years were recruited in this study. TFA of children was measured using clinical methods with the help of universal goniometer. Anthropometric variables like height, weight and body mass index (BMI) were noted for all subjects to establish their relationship with TFA. Results: Mean TFA was 4.84°±2.39° (Min=-0.75°, Max 12°) with range (4.59° to 5.08°). The knee angle at the age of 2 years was 1.21° mean valgus with range 0.82° to 1.59°, min -0.75° and max 2.25°, thereafter a progressive increase, with peak mean valgus of 6.63° ranging 5.91° to 7.34° at 7-8 years of age was noted. Later, there was notable decrease in TFA, which ultimately stabilized to a mean value of around 5°. Maximum mean valgus was 12° at 7-8 years of age group. Conclusion: This study provides age wise baseline data and range of physiological TFA. This data of 2 to <14 years age group tribal children of JH is helpful to the orthopaedic surgeons, physicians, paediatricians, radiologists, and physiotherapists for reconstruction and management of genu varus and valgus deformities.

Key Word: Genu varus, Genu valgus, Anterior superior iliac spine (ASIS), Intermalleolar Point, Tribal Children.