Article

Measurements of femoral and tibial torsion obtained from radiographs or computed
tomographic scans have been used to describe rotational malalignment of the lower
extremities and to clarify indications for surgery. A weak relationship between
anatomic torsion deformity and the resulting transverse plane gait pattern in
patients with cerebral palsy has been described, but the observations have not
yet been tested in an able-bodied patient population. We conducted a prospective
study to investigate the correlation of femoral torsion and tibial torsion as
measured by using computed tomography with transverse plane gait data for
patients with rotational malalignment. Twenty-six lower limbs from 26 patients
selected for surgery based on gait analysis were evaluated. Calculation of
Pearson correlations showed that increase of femoral anteversion resulted in
increase of pelvic range of motion. A very weak correlation between femoral
torsion and hip rotation (determination coefficient, R(2)=0.22) was found in a
linear regression model, whereas tibial torsion and knee rotation showed a strong
correlation (determination coefficient, R(2)=0.71). The correlation between the
foot progression angle and tibial torsion was higher than between the foot
progression angle and femoral torsion. We conclude that there is a considerable
dynamic influence of mechanisms of compensation, especially in the hip, that
should be considered when evaluating the torsional profile. We therefore
recommend conducting three-dimensional instrumented gait analysis for patients
undergoing surgical correction of rotational malalignment.
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Langue : ANGLAIS