Objective: The aim of this study was to investigate the effect of orthosis on tibiofemoral angle in infantile tibia vara. Method: A total of 14 subjects (9 male and 5 female) aged between 23-32 months were included in the study. The tibio femoral angles of the individuals were evaluated with universal goniometer before and 3 months after orthesis. Results and Conclusion: The mean tibiofemoral angle before orthosis was 14,36 ± 5,20 degrees in the subjects. The mean tibiofemoral angle after orthosis was 7.28 ± 2.68 degrees. It was determined that tibiofemoral angle decreased significantly after bracing (p<0.05). Bracing in infantile tibia patients may help reduce tibiofemoral angle in the early period. In the future; with larger sampling, control group and long-term follow-up studies can be planned.
- Alsancak, S., Güner, S., Kınık, H. 2013. Orthotic variations in the management of infantile tibia vara and the results of treatment. Prosthetics and Orthotics International;37(5):375-383.
- Arazi, M., Öğün, T. C., Memik, R. 2001. Normal Development of the Tibiofemoral Angle in Children: A Clinical Study of 590 Normal Subjects From 3 to 17 Years of Age. J Pediatr Orthop;21(2):264-267.
-Blount, W. P. 1966. Tibia vara, osteochondrosis deformans tibiae. Curr Pract Orthop Surg;3:141–156.
- Alekberov, C., Shevstov, V. I., Karatosun, V., Günal, I., Alici, E. 2003. Treatment of Tibia Vara by the Ilizarov Method. Clin Orthop Rel Res;409:199-208.
- Cheng, J. C., Chan, P. S., Chiang, S. C., Hui, P. W. 1991. Angular and rotational profile of the lower limb in 2630 Chinese children. J Pediatr Orthop;11(2):154–161.
- Desai, S. S., Shetty, G. M., Song, H. R., Lee, S. H., Kim, T. Y., Hur, C. Y. 2007. Effect of foot deformity on conventional mechanical axis deviation and ground mechanical axis deviation during single leg stance and two leg stance in genu varum. The Knee;14(6):452-457.
- Dietz, W. H., Gross, W. L., Kirkpatrick, J. A. 1982. Blount disease (tibia vara): Another skeletal disorder associated with childhood obesity. The Journal of Pediatrics;101(5):735-737.
- Doğan, A., Yalçınkaya, M., Mumcuoğlu, Y E. 2007. Tibia Vara. TOTBİD Dergisi;6(1-2):36-46.
- Funk, S. S., Mignemi, M. E., Schoenecker, J. G., Lovejoy, S. A., Mencio, G. A., Martus, J. E. 2016. Hemiepiphysiodesis implants for late-onset tibia vara: a comparison of cost, surgical success, and implant failure. J Pediatr Orthop;36(1):29-35.
- Gheluwe, B. V., Kirby, K. A., Hagman, F. 2005. Effects of Simulated Genu Valgum and Genu Varum on Ground Reaction Forces and Subtalar Joint Function During Gait. J Am Podiatr Med Assoc;95(6):531-541.
- Hoffman, M., Schrader, J., Applegate, T., Koceja, D. 1998. Unilateral Postural Control of the Functionally Dominant and Nondominant Extremities of Healthy Subjects. J Athl Train;33(4):319-322.
-Janoyer, M. 2019. Blount disease. Orthopaedics & Traumatology: Surgery & Research;105:111–121.
- Kakavandi, H. T., Sadeghi, H., Abbasi, A. 2017. The Effects of Genu Varum Deformity on the Pattern and Amount of Electromyography Muscle Activity Lower Extremity during the Stance Phase of Walking. Journal of Clinical Physiotherapy Research;2(3):104-109.
- LaMont, L. E., McIntosh, A. L., Jo, C. H., Birch, J. G., Johnston, C. E. 2019. Recurrence After Surgical Intervention for Infantile Tibia Vara: Assessment of a New Modified Classification. J Pediatr Orthop;39(2):65-70.
- Lavielle, J. M., Wiart, Y., Salmeron, F. 2010. Can Blount’s disease heal spontaneously? OTSR;96:531-535.
- Levine, A. M., Drennan, J. C. 1982. Physiological bowing and tibia vara: the metaphyseal–diaphyseal angle in the measurement of bowleg deformities. J Bone Joint Surg Am;64(8):1158–1163.
-Lisenda, L., Simons, D., Firth, G. B., Ramguthy, Y., Kebashni, T., Robertson, A. J. 2016. Vitamin D Status in Blount Disease. J Pediatr Orthop;36(5):59-62.
- Moghtadaei, M., Yeganeh, A., Boddouhi, B., Alaee, A., Farahini, H., Otoukesh, B. 2017. Effect of high tibial osteotomy on hip biomechanics in patients with genu varum: A prospective cohort study. Interventional Medicine & Applied Science;9(2):94–99.
- Sabharwal S. 2009. Blount disease. J Bone Joint Surg Am;91(7):1758–1776.
- Sabharwal, S., Sabharwal, S. 2017. Treatment of Infantile Blount Disease: An Update. J Pediatr Orthop;37(2):26-31.
- Salenius, P., Vankka, E. 1975. The development of tibiofemoral angle in children. J Bone Joint Surg Am;57(2):259–261.
- Shinohara Y, Kamegaya M, Kuniyoshi K, Moriya, H. 2002. Natural history of infantile tibia vara. J Bone Joint Surg Br;84(2):263–268.
- Miller, S., Radomisli, T., Ulin, R. 2000. Inverted Arcuate Osteotomy and External Fixation for Adolescent Tibia Vara. J Pediatr Orthop;20(4):450- 454.
- Vankka, E., Salenius, P.1982. Spontaneous Correction of Severe Tibiofemoral Deformity in Growing Children. Acta orthop. Scand.;53(4):567-570.
- Weiss, L., DeForest, B., Hammond, K., Schilling, B., Ferreira, L. 2013. Reliability of Goniometry-Based Q-Angle. American Academy of Physical Medicine and Rehabilitation;5(9):763-768.
- Yoo, J. H., Choi, I. H., Cho, T. J., Chung, C. Y., Yoo., W. J. 2008. Development of Tibiofemoral Angle in Korean Children. J Korean Med Sci;23(4):714–717.
Amaç: Çalışmanın amacı infantil tibia vara’da ortezlemenin erken dönemde tibiofemoral açı üzerine etkisini incelemektir. Yöntem: Çalışmaya yaşları 23-32 ay arasında, 9’u kız, 5’i erkek toplam 14 birey alındı. Bireylerin tibio femoral açıları universal gonyometre ile ortezleme öncesi ve ortezlemeden 3 ay sonra değerlendirildi. Bulgular ve Sonuç: Ortezleme öncesi bireylerin tibiofemoral açı ortalaması 14,36 ± 5,20 derece olarak ölçüldü. Ortezleme sonrası tibiofemoral açı ortalaması ise 7,28 ± 2,68 derece olarak belirlendi. Ortezleme sonrası tibiofemoral açının ortezleme öncesine göre anlamlı derecede azaldığı tespit edildi (p<0,05). İnfantil tibia vara’lı bireylerde ortezleme erken dönemde tibiofemoral açıyı azaltmada etkili olabilir. Gelecekte; daha büyük örnekleme sahip, kontrol grubunun dahil edildiği ve uzun dönem takipli çalışmalar planlanabilir.
- Alsancak, S., Güner, S., Kınık, H. 2013. Orthotic variations in the management of infantile tibia vara and the results of treatment. Prosthetics and Orthotics International;37(5):375-383.
- Arazi, M., Öğün, T. C., Memik, R. 2001. Normal Development of the Tibiofemoral Angle in Children: A Clinical Study of 590 Normal Subjects From 3 to 17 Years of Age. J Pediatr Orthop;21(2):264-267.
-Blount, W. P. 1966. Tibia vara, osteochondrosis deformans tibiae. Curr Pract Orthop Surg;3:141–156.
- Alekberov, C., Shevstov, V. I., Karatosun, V., Günal, I., Alici, E. 2003. Treatment of Tibia Vara by the Ilizarov Method. Clin Orthop Rel Res;409:199-208.
- Cheng, J. C., Chan, P. S., Chiang, S. C., Hui, P. W. 1991. Angular and rotational profile of the lower limb in 2630 Chinese children. J Pediatr Orthop;11(2):154–161.
- Desai, S. S., Shetty, G. M., Song, H. R., Lee, S. H., Kim, T. Y., Hur, C. Y. 2007. Effect of foot deformity on conventional mechanical axis deviation and ground mechanical axis deviation during single leg stance and two leg stance in genu varum. The Knee;14(6):452-457.
- Dietz, W. H., Gross, W. L., Kirkpatrick, J. A. 1982. Blount disease (tibia vara): Another skeletal disorder associated with childhood obesity. The Journal of Pediatrics;101(5):735-737.
- Doğan, A., Yalçınkaya, M., Mumcuoğlu, Y E. 2007. Tibia Vara. TOTBİD Dergisi;6(1-2):36-46.
- Funk, S. S., Mignemi, M. E., Schoenecker, J. G., Lovejoy, S. A., Mencio, G. A., Martus, J. E. 2016. Hemiepiphysiodesis implants for late-onset tibia vara: a comparison of cost, surgical success, and implant failure. J Pediatr Orthop;36(1):29-35.
- Gheluwe, B. V., Kirby, K. A., Hagman, F. 2005. Effects of Simulated Genu Valgum and Genu Varum on Ground Reaction Forces and Subtalar Joint Function During Gait. J Am Podiatr Med Assoc;95(6):531-541.
- Hoffman, M., Schrader, J., Applegate, T., Koceja, D. 1998. Unilateral Postural Control of the Functionally Dominant and Nondominant Extremities of Healthy Subjects. J Athl Train;33(4):319-322.
-Janoyer, M. 2019. Blount disease. Orthopaedics & Traumatology: Surgery & Research;105:111–121.
- Kakavandi, H. T., Sadeghi, H., Abbasi, A. 2017. The Effects of Genu Varum Deformity on the Pattern and Amount of Electromyography Muscle Activity Lower Extremity during the Stance Phase of Walking. Journal of Clinical Physiotherapy Research;2(3):104-109.
- LaMont, L. E., McIntosh, A. L., Jo, C. H., Birch, J. G., Johnston, C. E. 2019. Recurrence After Surgical Intervention for Infantile Tibia Vara: Assessment of a New Modified Classification. J Pediatr Orthop;39(2):65-70.
- Lavielle, J. M., Wiart, Y., Salmeron, F. 2010. Can Blount’s disease heal spontaneously? OTSR;96:531-535.
- Levine, A. M., Drennan, J. C. 1982. Physiological bowing and tibia vara: the metaphyseal–diaphyseal angle in the measurement of bowleg deformities. J Bone Joint Surg Am;64(8):1158–1163.
-Lisenda, L., Simons, D., Firth, G. B., Ramguthy, Y., Kebashni, T., Robertson, A. J. 2016. Vitamin D Status in Blount Disease. J Pediatr Orthop;36(5):59-62.
- Moghtadaei, M., Yeganeh, A., Boddouhi, B., Alaee, A., Farahini, H., Otoukesh, B. 2017. Effect of high tibial osteotomy on hip biomechanics in patients with genu varum: A prospective cohort study. Interventional Medicine & Applied Science;9(2):94–99.
- Sabharwal S. 2009. Blount disease. J Bone Joint Surg Am;91(7):1758–1776.
- Sabharwal, S., Sabharwal, S. 2017. Treatment of Infantile Blount Disease: An Update. J Pediatr Orthop;37(2):26-31.
- Salenius, P., Vankka, E. 1975. The development of tibiofemoral angle in children. J Bone Joint Surg Am;57(2):259–261.
- Shinohara Y, Kamegaya M, Kuniyoshi K, Moriya, H. 2002. Natural history of infantile tibia vara. J Bone Joint Surg Br;84(2):263–268.
- Miller, S., Radomisli, T., Ulin, R. 2000. Inverted Arcuate Osteotomy and External Fixation for Adolescent Tibia Vara. J Pediatr Orthop;20(4):450- 454.
- Vankka, E., Salenius, P.1982. Spontaneous Correction of Severe Tibiofemoral Deformity in Growing Children. Acta orthop. Scand.;53(4):567-570.
- Weiss, L., DeForest, B., Hammond, K., Schilling, B., Ferreira, L. 2013. Reliability of Goniometry-Based Q-Angle. American Academy of Physical Medicine and Rehabilitation;5(9):763-768.
- Yoo, J. H., Choi, I. H., Cho, T. J., Chung, C. Y., Yoo., W. J. 2008. Development of Tibiofemoral Angle in Korean Children. J Korean Med Sci;23(4):714–717.