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Femoral anteversion assessment: Comparison of physical examination, gait analysis, and EOS biplanar radiography.

Femoral anteversion assessment: Comparison of physical examination, gait analysis, and EOS biplanar radiography.
Author Information (click to view)

Westberry DE, Wack LI, Davis RB, Hardin JW,


Westberry DE, Wack LI, Davis RB, Hardin JW, (click to view)

Westberry DE, Wack LI, Davis RB, Hardin JW,

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Gait & posture 2018 03 2662() 285-290 pii S0966-6362(18)30256-X
Abstract
BACKGROUND
Multiple measurement methods are available to assess transverse plane alignment of the lower extremity.

RESEARCH QUESTION
This study was performed to determine the extent of correlation between femoral anteversion assessment using simultaneous biplanar radiographs and three-dimensional modeling (EOS imaging), clinical hip rotation by physical examination, and dynamic hip rotation assessed by gait analysis.

METHODS
Seventy-seven patients with cerebral palsy (GMFCS Level I and II) and 33 neurologically typical children with torsional abnormalities completed a comprehensive gait analysis with same day biplanar anterior-posterior and lateral radiographs and three-dimensional transverse plane assessment of femoral anteversion. Correlations were determined between physical exam of hip rotation, EOS imaging of femoral anteversion, and transverse plane hip kinematics for this retrospective review study.

RESULTS
Linear regression analysis revealed a weak relationship between physical examination measures of hip rotation and biplanar radiographic assessment of femoral anteversion. Similarly, poor correlation was found between clinical evaluation of femoral anteversion and motion assessment of dynamic hip rotation. Correlations were better in neurologically typical children with torsional abnormalities compared to children with gait dysfunction secondary to cerebral palsy.

SIGNIFICANCE
Dynamic hip rotation cannot be predicted by physical examination measures of hip range of motion or from three-dimensional assessment of femoral anteversion derived from biplanar radiographs.

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