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Bone Joint Res. 2013 Aug 14;2(8):155-61. doi: 10.1302/2046-3758.28.2000157. Print 2013.

Clinical tibiofemoral angle in south Indian children.

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Christian Medical College, Paediatric Orthopaedic Unit, Vellore 632004, Tamil Nadu, India.



The development of tibiofemoral angle in children has shown ethnic variations. However this data is unavailable for our population.


We measured the tibiofemoral angle (TFA) and intercondylar and intermalleolar distances in 360 children aged between two and 18 years, dividing them into six interrupted age group intervals: two to three years; five to six years; eight to nine years; 11 to 12 years; 14 to 15 years; and 17 to 18 years. Each age group comprised 30 boys and 30 girls. Other variables recorded included standing height, sitting height, weight, thigh length, leg length and length of the lower limb.


Children aged two to three years had a valgus angulation with a mean TFA of 1.8° (sd 0.65) in boys and 2.45° (sd 0.87) in girls. Peak valgus was seen in the five- to six-year age group, with mean TFAs of 6.7° (sd 1.3) and 7.25° (sd 0.64) for boys and girls, respectively. From this age the values gradually declined to a mean of 3.18° (sd 1.74) and 4.43° (sd 0.68) for boys and girls, respectively, at 17 to 18 years. Girls showed a higher valgus angulation than boys at all age groups.


This study defines the normal range of the TFA in south Indian boys and girls using an easy and reliable technique of measurement with a standardised custom-made goniometer. Cite this article: Bone Joint Res 2013;2:155-61.


Genu valgum; Goniometer; Intercondylar distance; Intermalleolar distance; Population; Tibiofemoral angle

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