Baruah R K, Kumar S, Harikrishnan S V
Department of Orthopaedics, Assam Medical College, Dibrugarh, Assam 786002, India.
J Child Orthop. 2017 Oct 1;11(5):339-347. doi: 10.1302/1863-2548.11.170047.
Physiological range of tibiofemoral angle (TFA) is poorly defined and may lead to unnecessary therapeutic interventions. Studies on TFA developmental pattern suggest that racial and ethnic differences are present; children in north-east India who have not yet been studied need to be evaluated.
Cross-sectional study of clinical TFA, intermalleolar distance and intercondylar distance in 1020 healthy north-east Indian children aged from 2 to 18 years was done. Height, weight and body mass index were also recorded.
At two years of age the mean TFA was valgus. The values reached a peak of 8.55° (standard deviation (SD) 1.01) valgus at seven years of age. The TFA then gradually stabilised to 3.18° (SD 1.18) valgus by 18 years of age. There was no significant difference in TFA between male and female patients.
The present study is the largest and only the third such study on Indian children and the first on healthy northeast Indian children. By the end of two years most children had valgus angulation. This, along with the peak angulation observed, was similar to most of the other studies. The age at peak angulation and subsequent stabilisation of valgus angulation varied greatly among children of different origins, especially non-Indian children.
Data can be used to identify children who require further follow-up/evaluation and can serve as guidelines during deformity correction and future studies. The development of TFA in this cohort is not different from other children of India but differs from children of other ethnic origins.
胫股角（TFA）的生理范围界定不清，可能导致不必要的治疗干预。关于TFA发育模式的研究表明存在种族和民族差异；印度东北部尚未被研究的儿童需要进行评估。
对1020名年龄在2至18岁的印度东北部健康儿童进行了临床TFA、内踝间距和髁间间距的横断面研究。还记录了身高、体重和体重指数。
两岁时平均TFA为外翻。七岁时外翻值达到峰值8.55°（标准差（SD）1.01）。然后TFA逐渐稳定，到18岁时外翻至3.18°（SD 1.18）。男性和女性患者的TFA无显著差异。
本研究是关于印度儿童的规模最大且仅有的第三项此类研究，也是第一项针对印度东北部健康儿童的研究。到两岁末，大多数儿童有外翻成角。这与观察到的峰值成角情况一起，与大多数其他研究相似。不同来源儿童，尤其是非印度儿童，峰值成角年龄和随后外翻成角的稳定情况差异很大。
这些数据可用于识别需要进一步随访/评估的儿童，并可作为畸形矫正和未来研究的指导。该队列中TFA的发育与印度其他儿童无异，但与其他种族儿童不同。
