Physiological alignment of the lower limbs changes during childhood. A clinical Study in South-West Greece

It is well known that the physiological alignment of the lower limbs changes during the first years of life. Mild to moderate bowlegs in newborns and knock-knees in early childhood are well-defined and quite common orthopaedic problems. The established reference values of paediatric lower limb alignment are based on clinical or/and radiographic measurements of the tibiofemoral (TF) angle and the Intermalleolar (IM) and Intercondylar (IC) distance. In our study, we determine the mean values and normal limits for the TF angle and the IC/IM distance of 316 normal children in South-West Greece. In total, 160 boys and 156 girls aged from 3 to 9 years were examined using clinical methods. The average value of the tibiofemoral angle starts around 7o at the age of 3 years and gradually decreases to under 4o at the age of 7 to 8 years. The average value of the IM distance ranges from greater than 3.5 cm at the age of 3 years and progressively falls to under 2 cm at the age of 7 to 8 years. We noted significantly different results than other similar reports. These differences may reflect racial differences between Greek children and those of other races.