COMPUTED-TOMOGRAPHY FOR FEMORAL AND TIBIAL TORSION IN CHILDREN WITH CLUBFOOT

Forty-seven children with 70 clubfeet had computed tomography studies performed to determine the degree of femoral, tibial, and total limb t orsion in both lower limbs. The total limb torsion angle (angle betwee n the axis of the femoral neck and the axis of the ankle), which descr ibes the relationship between femoral and tibial torsion, was used to evaluate the whole rotational deformity of the lower limb. The childre n were between the ages of 2 and 10 years (mean, 5 years) at the time of the computed tomography study. The mean femoral torsion was 25 degr ees in the limbs with a clubfoot and 23 degrees in the contralateral l imbs of patients with a unilateral clubfoot. The mean tibial torsion w as 25 degrees in the limbs with a clubfoot and 24 degrees in the contr alateral limb of patients with a unilateral clubfoot. The authors obse rved decreases of anterior femoral torsion corresponding to increases in age, consistent with the observations made by other authors of stud ies of children without clubfoot. External tibial torsion increased wi th age, with similar values in limbs with and without clubfoot. Ten li mbs (nine with clubfoot, one without clubfoot) had femoral torsion gre ater than the mean plus one standard deviation and 12 limbs (eight wit h clubfoot, four without clubfoot) had tibial torsion less than the me an minus one standard deviation. The authors found four limbs (all wit h clubfoot) in three patients with lower than the mean minus one stand ard deviation of the total limb torsion angle (intoeing), Overall, the re was no appreciable difference in the amount of femoral or tibial to rsion in limbs with and without a clubfoot.