Femoral Anteversion in Children With Cerebral Palsy

Davids, Jon R.; Marshall, Amanda D; Blocker, Edward R; Frick, Steven L.; Blackhurst, Dawn W.; Skewes, E

doi:10.2106/00004623-200303000-00013

Cited by 60 publications

(7 citation statements)

References 24 publications

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“…However, Davids et al could show that measurement accuracy is compromised by femoral specimen malalignment even if three-dimensional volumetric CT images were used under laboratory conditions. [ 22 ] This finding indicates that widely established software solutions and calculation models might still lack the accuracy needed to precisely determine anatomic angles at the proximal femur. In the present study, a novel three-dimensional modeling and analytical technology (Stryker Orthopaedics Modeling and Analytics system, SOMA) was applied to a large CT database.…”

Section: Introductionmentioning

confidence: 99%

Determination of Femoral Neck Angle and Torsion Angle Utilizing a Novel Three-Dimensional Modeling and Analytical Technology Based on CT Datasets

et al. 2016

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IntroductionExact knowledge of femoral neck inclination and torsion angles is important in recognizing, understanding and treating pathologic conditions in the hip joint. However, published results vary widely between different studies, which indicates that there are persistent difficulties in carrying out exact measurements.MethodsA three dimensional modeling and analytical technology was used for the analysis of 1070 CT datasets of skeletally mature femurs. Individual femoral neck angles and torsion angles were precisely computed, in order to establish whether gender, age, body mass index and ethnicity influence femoral neck angles and torsion angles.ResultsThe median femoral neck angle was 122.2° (range 100.1–146.2°, IQR 117.9–125.6°). There are significant gender (female 123.0° vs. male 121.5°; p = 0.007) and ethnic (Asian 123.2° vs. Caucasian 121.9°; p = 0.0009) differences. The median femoral torsion angle was 14.2° (-23.6–48.7°, IQR 7.4–20.4°). There are significant gender differences (female 16.4° vs. male 12.1°; p = 0.0001). Femoral retroversion was found in 7.8% of the subjects.ConclusionPrecise femoral neck and torsion angles were obtained in over one thousand cases. Systematic deviations in measurement due to human error were eliminated by using automated high accuracy morphometric analysis. Small but significant gender and ethnic differences were found in femoral neck and torsion angles.

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Section: Introductionmentioning

confidence: 99%

Determination of Femoral Neck Angle and Torsion Angle Utilizing a Novel Three-Dimensional Modeling and Analytical Technology Based on CT Datasets

et al. 2016

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“…The assessment of skeletal malaligments is of paramount importance in surgical decision-making for children with CP [22]. It is usually based on physical examination and 2D X-ray imaging [7,23].…”

Section: Three-dimensional Skeletal Reconstructionmentioning

confidence: 99%

A New Approach in the Clinical Decision - Making for Cerebral Palsy Using Three - Dimensional Subject - Specific Musculoskeletal Reconstructions

Massaad¹,

Assi²,

Bakouny³

2016

LMJ

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HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…The assessment of skeletal malalignments is important in surgical decision-making for children with CP [10], and is usually based on physical examination [11], two-dimensional X-Ray imaging [12] and three-dimensional (3D) gait analysis [13]. However, torsional abnormalities, such as abnormal femoral anteversion (FA) or tibial torsion (TT), require measurements in 3D.…”

Section: Introductionmentioning

confidence: 99%

“…Three-dimensional computed tomography (CT) is a reliable tool to measure FA and TT [10]. This technique has been used to measure these parameters in children with CP [6].…”

Section: Introductionmentioning

confidence: 99%

“…This technique has been used to measure these parameters in children with CP [6]. However, the use of this technique is limited by the high exposure to radiation [14] and the fact that its accuracy is affected by positional variables [10], which are difficult to control in children with CP. For these reasons, 3D CT scan is not routinely used to assess lower limb skeletal abnormalities in children with CP.…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional evaluation of skeletal deformities of the pelvis and lower limbs in ambulant children with cerebral palsy

et al. 2016

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Skeletal abnormalities, affecting posture and walking pattern, increase with motor impairment in children with cerebral palsy (CP). However, it is not known whether these skeletal malalignments occur in children with slight motor impairment. Our aim was to evaluate skeletal malalignment at the level of the pelvis and lower limbs in ambulant children with CP, with slight motor impairment, using a low dose biplanar X-ray technique. Twenty-seven children with spastic CP (mean age: 10.9±4years, 7 Hemiplegia, 20 Diplegia, GMFCS levels I:17, II:10), with no previous treatments at the hips and knees, underwent EOS(®) biplanar X-rays. A control group consisting of 22 typically developing children was also included. Three-dimensional reconstructions of the pelvis and lower limbs were performed in order to calculate 11 radiological parameters related to the pelvis, acetabulum and lower limbs. Pelvic incidence and sacral slope were significantly increased in children with CP compared to TD children (48°±7° vs. 43°±8°, 42°±7° vs. 38°±5°, respectively, p=0.003). Acetabular parameters did not significantly differ between the two groups. Femoral anteversion and neck shaft angle were significantly increased in children with CP (25°±12° vs. 14°±7°, p<0.001; 134°±5° vs. 131°±5°, p=0.005 respectively). No difference was found for tibial torsion. This study showed that even slightly impaired children with CP have an anteverted and abducted femur and present positional and morphological changes of the pelvis in the sagittal plane. The orientation of the acetabulum in 3D seems to not be affected when children with CP present slight motor impairment.

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Femoral Anteversion in Children With Cerebral Palsy

Cited by 60 publications

References 24 publications

Determination of Femoral Neck Angle and Torsion Angle Utilizing a Novel Three-Dimensional Modeling and Analytical Technology Based on CT Datasets

Determination of Femoral Neck Angle and Torsion Angle Utilizing a Novel Three-Dimensional Modeling and Analytical Technology Based on CT Datasets

A New Approach in the Clinical Decision - Making for Cerebral Palsy Using Three - Dimensional Subject - Specific Musculoskeletal Reconstructions

Three-dimensional evaluation of skeletal deformities of the pelvis and lower limbs in ambulant children with cerebral palsy

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