Normal Development of the Tibiofemoral Angle in Children: A Clinical Study of 590 Normal Subjects From 3 to 17 Years of Age

Abstract

In evaluation of genu varum–genu valgum, tibiofemoral (TF) angle and intercondylar (IC) or intermalleolar (IM) distance are commonly measured. In this study, we determined mean values and normal limits for TF angle and IC/IM distance in 590 normal Turkish children (287 girls and 303 boys) aged from 3 to 17 years using clinical methods. We noted a significantly higher degree of valgus angle than that in previous reports. The maximal mean valgus angle was 9.6 degrees at 7 years for boys and 9.8 degrees at 6 years for girls. These differences were considered racial differences between Turkish children and those of other races. Turkish children, aged between 3 and 17 years, exhibited ≤11 degrees physiologic valgus. A measurable varus angle or a valgus higher than 11 degrees during this period should be considered abnormal.