title: Gait deviations and compensations in pediatric patients with increased femoral torsion.
abstract: Coxa antetorta describes an abnormal torsion of the femur. It is commonly considered a cosmetic problem and is treated surgically only in severe cases and the presence of physical complaints. The purpose of this study was to identify deviations in gait kinematics and kinetics in pediatric patients caused by coxa antetorta and to categorize these deviations into primary and secondary deviations. We conducted a retrospective, cross-sectional three-dimensional (3D) gait analysis study to detect gait deviations in adolescents (n = 18; age range 10.5-17.5 years) with coxa antetorta compared to age-matched healthy control subjects (n = 17). Principal component (PC) analysis was used for data reduction. Linear mixed models applied to PC-scores were used to estimate the main effects within retained PCs followed by a post-hoc subgroup analysis. Patients walked with smaller external foot progression angle, greater knee adduction, more internally rotated and flexed hips and greater anterior pelvic tilt. Subgroup analysis revealed that-depending on knee alignment-patients had higher knee and hip adduction moments. These deviations in joint kinematics and kinetics may be associated with physical complaints and accelerated development of osteoarthritis. Assessment of gait deviations related to coxa antetorta using 3D gait analysis may be an additional tool in individual clinical decision-making.
authors.affiliation: Institute of Physiotherapy, School of Health Professions, University of Applied Sciences Zurich, Winterthur, Switzerland; Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland.
authors.forename: Marina
authors.initials: M
authors.lastname: Bruderer-Hofstetter
authors.forename: Verena
authors.initials: V
authors.lastname: Fenner
authors.forename: Erika
authors.initials: E
authors.lastname: Payne
authors.forename: Katja
authors.initials: K
authors.lastname: Zdenek
authors.forename: Harry
authors.initials: H
authors.lastname: Klima
authors.forename: Regina
authors.initials: R
authors.lastname: Wegener
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D060750:Bone Anteversion / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000503:physiopathology*; D005684:Gait; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D025341:Principal Component Analysis; D012189:Retrospective Studies
keywords: coxa antetorta; femoral torsion; gait analysis; linear mixed model; principal component analysis