title: Timely diagnosis of malalignment of the distal extremities is crucial in morbidly obese juveniles.
abstract: OBJECTIVE
  To determine i) whether obesity in childhood can be related to malalignment of the distal extremities, ii) the proportion of genu valgum malalignment and abduction setting, and iii) the respective deviation dominance in children who are morbidly obese.
  
  
  METHODS
  31 morbidly obese Caucasian children (16 males) recruited for the STYJOBS Study (ClinicalTrials.gov Identifier NCT00482924) with a mean age of 13.9 ± 0.5 years, a mean height of 162.3 ± 2.7 cm, a mean weight of 90.62 ± 5.0 kg, and a mean BMI of 33.8 ± 1.2 kg/m(2) were clinically examined using the Mikulicz line in order to assess load distribution on the knee joint. 21 participants received a whole-leg X-ray because of a clinically estimated malalignment.
  
  
  RESULTS
  8/31 participants examined were diagnosed with genu valgum, 1/31 with genu varum, and 22/31 did not have any malalignment of the femur or tibia. The majority of genu valgum presentation was due to femoral deviation. Of those without malalignment, 4/22 participants had an abduction setting, while 2/22 showed an adduction of the leg.
  
  
  CONCLUSIONS
  Genu valgum as a predominant malalignment of the distal extremities is frequent in youth with morbid obesity. Timely guided correction of angular deformity of the knee seems pivotal in order to avoid osteotomy or osteoarthritis later in life.
authors: Department of Orthopedics, Paracelsus Medical University, Salzburg, Austria.
authors: Franz
authors: F
authors: Landauer
authors: Gerda
authors: G
authors: Huber
authors: Katharina
authors: K
authors: Paulmichl
authors: Grace
authors: G
authors: O'Malley
authors: Harald
authors: H
authors: Mangge
authors: Daniel
authors: D
authors: Weghuber
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D017760:Bone Malalignment / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D001842:Bone and Bones / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D056304:Genu Valgum / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D007866:Leg / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000000981:diagnostic imaging; D010027:Osteotomy; D015995:Prevalence; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging; D016474:Weight-Bearing; D044465:White People