KMID : 1140920180420010137
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Annals of Rehabilitation Medicine 2018 Volume.42 No. 1 p.137 ~ p.144
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Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: One-Year Follow-Up Study
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Kong Min-Sik
Jo Hong-Sik Lee Chang-Han Chun Se-Woong Yoon Chul-Ho Shin Hee-Suk
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Abstract
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Objective: To evaluate femoral anteversion angle (FAA) change in children with intoeing gait depending on age, gender, and initial FAA using three-dimensional computed tomography (3D-CT).
Methods: The 3D-CT data acquired between 2006 and 2016 were retrospectively reviewed. Children 4 to 10 years of age with symptomatic intoeing gait with follow-up interval of at least 1 year without active treatment were enrolled. Subjects were divided into three groups based on age: group 1 (¡Ã4 and <6 years), group 2 (¡Ã6 and <8 years), and group 3 (¡Ã8 and <10 years). Initial and follow-up FAAs were measured using 3D-CT. Mean changes in FAAs were calculated and compared.
Results: A total of 200 lower limbs of 100 children (48 males and 52 females, mean age of 6.1¡¾1.6 years) were included. The mean follow-up period was 18.0¡¾5.4 months. Average initial and follow-up FAA in children with intoeing gait was 31.1¡Æ¡¾7.8¡Æ and 28.9¡Æ¡¾8.2¡Æ, respectively. The initial FAA of group 1 was largest (33.5¡Æ¡¾7.7¡Æ). Follow-up FAA of group 1 was significantly reduced to 28.7¡Æ¡¾9.2¡Æ (p=0.000). FAA changes in groups 1, 2, and 3 were -6.5¡Æ¡¾5.8¡Æ, -6.4¡Æ¡¾5.1¡Æ, and -5.3¡Æ¡¾4.0¡Æ, respectively. These changes of FAA were not significantly (p=0.355) different among the three age groups. However, FAA changes were higher (p=0.012) in females than those in males. In addition, FAA changes showed difference depending on initial FAA. When initial FAA was smaller than 30¡Æ, mean FAA change was -5.6¡Æ¡¾4.9¡Æ. When initial FAA was more than 30¡Æ, mean FAA change was -6.8¡Æ¡¾5.4¡Æ (p=0.019).
Conclusion: FAA initial in children with intoeing gait was the greatest in age group 1 (4?6 years). This group also showed significant FAA decrease at follow-up. FAA changes were greater when the child was a female, younger, and had greater initial FAA.
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KEYWORD
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Three-dimensional imaging, Bone anteversion, In-toeing gait
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