Developmental Pattern of Tibio-Femoral Angle in a Cohort of Nigerian Children: A Preliminary Report

Abstract

A cohort measurement of tibio-femoral angle (TFA) is more meaningful and reliable than a cross-sectional survey in investigating TFA pattern of development. This study reports the pattern of knee angle development in a cohort of 152 normal Nigerian children during the first 12 months of life. The infants’ tibio-femoral angle, inter-condylar, and inter-malleoli distances were measured at monthly intervals using clinical methods. Age-reference values were generated. Results showed that the developmental pattern of tibio-femoral angle is extreme varus at birth with values ranging from 5°to 25°. The mean varus at birth (13.2±3.7°) decreased to reach the lowest value (5.6±0.7°) at nine months and then rose slightly to (6.9±1.2°) at 12 months. None of the infants exhibited a measurable valgus angle. In conclusion, the chronological development of TFA in these cohort Nigerian infants was varus, maximal at birth and decreasing during first 12 months of life. The age-reference values herewith generated may serve as a useful guide in evaluating lower limb alignment in Nigerian children, age 0 to 12 months.