How to cite this article: Dhananjay Kumar, Shanmukha Varalakshmi Vangara, Patnaik V V Gopichand, Nidhi Puri . Growth pattern of genu varum and valgum in Indian tribal children of Jharkhand state. MedPulse – International Journal of Anatomy. November 2018; 8(2): 14-19. http://www.medpulse.in/Anatomy Original Research Article Growth pattern of genu varum and valgum in Indian tribal children of Jharkhand state Dhananjay Kumar 1 , Shanmukha Varalakshmi Vangara 2* , Patnaik V V Gopichand 3 , Nidhi Puri 4 1,2 Assistant Professor, Shri Ram M urti Smarak Institute of M edical Sciences, Bhojipura, Bareilly, U.P, INDIA. 3 Professor and Dean, M amata M edical College and Hospital, Hyderabad, Telangana, INDIA. 4 Professor, Dr Yashwant Singh Parmar Government M edical College Nahan, Himachal Pradesh, INDIA. Email: lakshmidhananjay@gmail.com Abstract Background: Genu varum- valgum can be determined by measuring tibiofemoral angle (TFA), intercondylar distance (ICD) and intermalleolar distance (IMD). Current study establishes the reference values of TFA (degrees) in normal healthy tribal population of Ranchi district. Previous studies have noted the regional differences in TFA. Despite its clinical importance and social relevance, literature is scanty in Indian population especially in northern Indian tribal children. Material and Methods: A cross sectional study is performed to assess the knee angle. 360 tribal children aged between 2-14 years were recruited in this study. TFA of children was measured using clinical methods with the help of universal goniometer. Anthropometric variables like height, weight and body mass index (BMI) were noted for all subjects to establish their relationship with TFA. Results: Mean TFA was 4.84°±2.39° (Min=-0.75°, Max 12°) with range (4.59° to 5.08°). The knee angle at the age of 2 years was 1.21° mean valgus with range 0.82° to 1.59°, min -0.75° and max 2.25°, thereafter a progressive increase, with peak mean valgus of 6.63° ranging 5.91° to 7.34° at 7-8 years of age was noted. Later, there was notable decrease in TFA, which ultimately stabilized to a mean value of around 5°. Maximum mean valgus was 12° at 7-8 years of age group. Conclusion: This study provides age wise baseline data and range of physiological TFA. This data of 2 to <14 years age group tribal children of JH is helpful to the orthopaedic surgeons, physicians, paediatricians, radiologists, and physiotherapists for reconstruction and management of genu varus and valgus deformities. Key Word: Genu varus, Genu valgus, Anterior superior iliac spine (ASIS), Intermalleolar Point, Tribal Children. * Address for Correspondence: Dr. Shanmukha Varalakshmi Vangara, Assistant Professor, Department of Anatomy, SRMS-IMS, Bhojipura, Bareilly. Email: lakshmidhananjay@gmail.com Received Date: 13/09/2018 Revised Date: 22/10/2018 Accepted Date: 08/11/2018 DOI: https://doi.org/10.26611/1001823 INTRODUCTION The mid longitudinal axes between femur and tibia form an angle, which changes from birth to age of 9-10 years (yrs). The angulation between femur and tibia presents genu varum at birth, which changes to genu valgum as the child starts to walk. Genu varum (GVR) is also termed as ‘bowleg’. It is an outward curvature of both femur and tibia, marked by medial angulation of the leg in relation to the thigh. Genu valgum (GVL), commonly called as ‘knock-knees’ is a condition where both knees touch one another when the legs are straight. GVR and GVL are relatively common among all angular deformities of lower limb in children. Mild to moderate bowlegs in newborn and knock- knees in early childhood are well- defined common orthopaedic problems. Both paediatricians and paediatric orthopaedic surgeons are frequently encountering these situations. Even though these conditions are benign and self-limiting, these deformities cause a great concern to the parents and relatives, 1 such apprehension among parents forces the physicians to conduct physical or radiological examinations. 2 The amount of varosity and valgosity is age specific, gender specific and racial specific. 3 It also depends on daily habits of the child. GVR and GVL are measured in either terms of tibiofemoral angle (TFA) in degrees (°) or intercondylar distance (ICD) and Access this article online Quick Response Code: Website: www.medpulse.in Accessed Date: 17 November 2018