Normal Limits of Tibiofemoral Angle and Intermalleolar Distances in Children

The alignment of lower limbs change with growth and accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. We are reporting the normal variations in tibiofemoral alignment in young people in a region of Iran. A cross-sectional study on 853 children (455 girls 398 boys) of 3 to 16 years age was performed. Tibiofemoral angles and intermalleolar distances were measured in standing position. Normal limits of tibiofemoral angles and intermalleolar distances were separately determined based on age and sex. A valgus alignment was observed in all. The tibiofemoral angles in boys between ages 3 to 7 years were 7.1±0.35 and 4.97±0.36 between 8 to 16 years of age. The tibiofemoral angle in girls aged 3 to 7 years were 7.1± 0.38 and in girls of 8 to 16 years were 4.95±0.37 degrees. There was no significant difference between the tibiofemoral angle in girls and boys. The intermalleolar distance in boys of 3 to 7 years old was 2.7±0.9 and in boys of 8 to 16 years were 1.4±0.86 centimeters. The intermalleolar distance was 2.6±0.88 centimeters in 3 to 7 year old girls and 2.29±0.93 centimeters in 8 to 16 year old girls. Pierson correlation coefficient showed a reverse relationship between tibiofemoral angle and intermalleolar distance. The tibiofemoral alignment in Iranian children is similar to that of Europe North America and Turkey but different from Chinese children.