International Journal of Research in Medical Sciences | February 2021 | Vol 9 | Issue 2 Page 494
International Journal of Research in Medical Sciences
Gupta R et al. Int J Res Med Sci. 2021 Feb;9(2):494-497
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Clinical measurement of intermalleolar distance in
Western Indian population
Renu Gupta*, Ashish Kumar Nayyar, Surajit Ghatak
INTRODUCTION
At any orthopedic clinic, angular malformations around
the knee are one of the common presentations.
Determining which of these are pathological often cause
apprehension in the population, although most of these
conditions are commonly benign and self-limiting.
Intermalleolar distance is the distance between the two
medial malleoli of the ankles keeping the femoral
condyles touching each other and is an important
anthropometric tool while assessing the angular status of
the lower limb.
1,2
In classifying individuals in a
population as having genu valgum (knock-knees), genu
varus (bowed legs) or normal limbs, the intermalleolar
measurement is commonly used in the orthopaedic
practice. The determination of individuals as having
valgus or varus deformity assumes significance in
recruitment into armed forces and para-military forces.
Lateral femoral neck anteversion coupled with lateral
tibial torsion leads to Genu valgum (knock-knee).
3
This
structural nonconformity causes abnormal lateral stress
on the patella so that legs are bent inward in the upright
position. In those instances where both the knees are
touching, then ankles also touch. However in a person
with knock-knee, the knees typically touch each other but
ankles remain separated by a distance. Occurrence of
Genu valgum or Knock-knee may be physiological or
pathological.
4,5
Physiological genu valgum is often seen
in children younger than six years and gets resolved by
age six. Pathological genu valgum is seen to occur in
adolescent and adults and may be acquired or congenital.
Acquired genu valgum may be caused due to infectious
diseases like polio, maltreated (or untreated) traumatic
injuries of the lower limb. Congenital genu valgum may
be due to genetic disorders like Down’s syndrome,
Marfan syndrome, hereditary multiple exostoses,
neurofibromatosis and untreated congenital
abnormalities.
Department of Anatomy, AIIMS Jodhpur, Rajasthan, India
Received: 27 November 2020
Accepted: 31 December 2020
*Correspondence:
Dr. Renu Gupta,
E-mail: drrenu.gupta79@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20210430
ABSTRACT
Background: Angular deformities around the knee are one of the common basis of presentation at orthopaedic clinic
and intermalleolar distance (IMD) is an essential anthropometric tool for evaluation of the angular status of the lower
limb.
Methods: 500 healthy (330 male and 170 female) subjects between 20 to 40 years of age were taken for IMD
measurement in standing and supine position by digital vernier caliper.
Results: The normal range of IMD in western Indian population in between 32-58 mm. IMD in standing position was
42.47 mm with (95% CI = 40.51 to 44.42 mm) and in supine position was 34.45 mm with (95% CI = 32.78 to 36.13
mm). Mean IMD in male in standing position was 40.01 mm while in female it was 43.74 mm observed. Statically
significant difference was observed in posture change and according to age.
Conclusions: Significantly higher value in female, in standing position and in higher age group were observed.
Keywords: Intermalleolar distance, Standing position, Supine position, Western Indian population