Persistent Foetal Alignment of the Hip

Abstract

1. The condition of persistent foetal alignment is discussed both as an entity and in its relationship to the development of a normal hip, and also to the varying degrees of congenital dislocation of the hip. A possible connection with osteoarthritis is also mentioned. 2. The secondary deformities to which it may give rise are discussed, and the way in which both primary and secondary deformities may be corrected is described. 3. The importance of estimating rotation with the hip in full extension is emphasised. 4. The results in eight patients so treated are mentioned.

Determination and Significance of Femoral Neck Anteversion

“…An increased or a decreased FNA angle has been linked to many different lowerextremity problems, including osteoarthritis of the hip, coxa plana, slipped capital femoral epiphysis, congenital hip dysplasia, acetabular labral tears, and in-toeing and out-toeing of the lower extremities. 1,[3][4][5][6][7][8]14,23,25,28,29,31,[42][43][44][45][46][47][48][49] Identifying when an increased or decreased FNA angle is present may help physical therapists recognize patients who may be at risk for developing hip or other problems associated with in-toeing or out-toeing. Moreover, asymmetries in hip joint rotation also have been associated with low back and regional pain in the sacroiliac joint.…”

“…In 1957, Sommerville 23 reported that extreme differences between hip medial and lateral rotation are related to femoral torsion problems in children. Crane 1 found that differences between hip medial and lateral rotation were associated with change in FNA and with the toeing-in and toeing-out of the lower extremity.…”

“…[1][2][3][4][5][6][7]9 Excessive in-toeing or out-toeing has been shown to be related to many different compensatory problems of the lower extremities, including tibial torsion, genu valgum, genu valgus, pes planus, pes equinus, and metatarsus varus. [1][2][3][4][5][6]8,23 Many other studies 1,[3][4][5][6][7][8]14,23,25,28,29,31,[41][42][43][44][45][46][47][48][49] have shown the relationship between an increased or decreased FNA angle and other orthopedic problems of the lower extremity.…”

Femoral cam deformity due to anterior capsular force: A theoretical model with MRI and cadaveric correlation

“…23 The decrease in femoral anteversion after walking age in childhood is attributed to this posteriorly directed iliofemoral ligament force. 24 In a study demonstrating that the thickest portion of the iliofemoral ligament is between the 1 and 2 o' clock positions of the anterosuperior femoral neck, 15 which corresponds to the most common location of the femoral cam lesion, 4,14 the authors suggest that the ligament becomes thick in this location in response to the cam lesion. We propose the opposite -the cam prominence develops in response to capsular pressure on the growth plate.…”

Surgical correction of idiopathic medial femoral torsion

“…There are many surgical techniques with osteotomies carried out in the supracondylar [2,5,13,18], subtrochanteric [1,15,16,18,21,22] and the intertrochanteric areas [13]. Various means of fixation have been described [13,15,18,26].…”