veículo de difusão de informações em análise de marcha, reabilitação e biomecânica, captura de movimento para produções industriais
clinical gait analysis, rehabilitation and biomechanics, industrial "motion capture" (MoCap)



Biomecânica: Torção Tibial - Tibial Torsion

  • The anatomical tibial axis
  • RELIABLE ROTATIONAL ORIENTATION IN KNEE REPLACEMENT
    "The rotational alignment of the tibia is an unresolved issue in knee replacement. A poor functional outcome may be due to malrotation of the tibial component. Our aim was to find a reliable method for positioning the tibial component in knee replacement."

    J. P. Cobb, H. Dixon, W. Dandachli, F. Iranpour - Charing Cross Hospital, London, England



  • Tibial torsion: Significance and measurement
  • Guest editorial:
    Following the acceptance for publication of the article by Hazlewood et al. in a recent issue of
    Gait & Posture we were invited by the Editor in Chief to comment on the challenging issue of measuring tibial torsion.

    Jon R. Davids, Roy B. Davis - Motion Laboratory, Shriners Hospital for Children, Greenville, SC



    A-B

  • A Comparison of Three Methods of Measuring Tibial Torsion
  • A Comparison of Three Methods of Measuring Tibial Torsion in Children with Myelomeningocele and Normally Developing Children

    "Abnormal tibial torsion is a common pediatric problem, and there are many existing measurement methods. The purpose of this study was to compare three methods of measuring tibial torsion for its evaluation: computed tomography, physical examination, and motion capture."


  • A comparison of ultrasound to goniometric and inclinometer measurements
  • A comparison of ultrasound to goniometric and inclinometer measurements of torsion in the
    tibia and femur

    "Torsions in the tibia and femur are important measurements for clinicians and researchers. A safe, accurate and time efficient tool is needed to advance the study of torsion.This study compared ultrasound and goniometric measures of torsion and also determined the repeatability of the goniometric techniques."


  • A comparison of four in vivo methods of measuring tibial torsion
  • "Tibial torsion, twisting of the tibia about its longitudinal axis, varies during development and early childhood. Knowledge of the normal range of tibial torsion at various ages and its accurate clinical measurement is important in the assessment of the extent of a torsional deformity. To evaluate tibial torsion a reliable technique for its measurement in vivo is therefore required. The aim of this study was to determine which of 4 existing in vivo methods of measuring tibial torsion was the most accurate and had the highest repeatability, by comparing them with direct measurement of the tibia."
  • Alternative methods for measuring tibial torsion
  • "This study introduces several new techniques for determining tibial torsion using motion analysis data. Analysis of correlations suggests that the new techniques may be more clinically valuable than the traditional bi-malleolar axis measurement".
  • Apresentação de um novo dispositivo para mensuração do ângulo de torção da perna
  • "Evaluation of new device for measuring the leg torsion angle"

    C-K

  • Correction of combined tibial torsion and valgus deformity of the foot
  • "Patients with spina bifida cystica commonly have significant disability from a combination of valgus deformity of the ankle and subtalar joints with lateral tibial torsion and plano-abduction deformity of the foot. These deformities can be corrected by a single procedure which combines a supramalleolar tibial osteotomy with a lateral inlay triple fusion."
  • Effects of Lower Limb Torsion on Ankle Kinematic Data During Gait Analysis
  • "VICON Clinical Manager (VCM - Vicon) software is widely used for gait analysis and has four methods for computing ankle plantarflexion–dorsiflexion motion and transverse plane ankle rotation profiles. The authors evaluated 14 subjects with a diagnosis of spastic cerebral palsy and tibial torsion ranging from 39° internal torsion to 90° external torsion, using the four different processing methods."
  • Influence of Lower-Limb Torsion on Long-Term Outcomes of Tibial Valgus Osteotomy
  • Influence of Lower-Limb Torsion on Long-Term Outcomes of Tibial Valgus Osteotomy for Medial Compartment Knee Osteoarthritis

    "The results of tibial osteotomy used to treat osteoarthritis of the medial compartment of the knee deteriorate over time even when the initial correction is optimal. Studies have shown that tibial and femoral torsion and the femorotibial index (tibial torsion minus femoral torsion) contribute, together with coronal malalignment, to the development of single-compartment knee osteoarthritis. The objective of our study was to evaluate the impact of femoral and tibial torsion and of coronal realignment on the long-term clinical and radiographic outcomes of valgus tibial osteotomy."

    L, M-S

  • Length and torsion of the lower limb
  • "Corrective osteotomies are often planned and performed on the basis of normal anatomical proportions. We have evaluated the length and torsion of the segments of the lower limb in normal individuals, to analyse the differences between left and right sides, and to provide tolerance figures for both length and torsion."
  • Measuring Femoral and Tibial Torsion in Children with Cerebral Palsy
  • "Lower limb torsional deformity is one of the most common musculoskeletal pathologies in children with cerebral palsy. Lower limb torsional deformity may cause many functional issues, such as problems of intoeing or out-toeing gait pattern and decreased energy efficiency during walking. Understanding more about how the rotational profile should be measured and the measurement accuracy enables more precise location of the deformity and should improve clinical treatment decision-making. In this chapter, we are going to discuss the measuring techniques for lower limb torsional deformities, specifically tibial torsion and femoral anteversion or torsion, which are described in the literature."
  • Mensuração do ângulo de torção tibial numa população adulta
  • Mensuração do ângulo de torção tibial numa população adulta jovem por meio de um novo dispositivo
    Measurement of tibial torsion angle in a young adult population with a new device

    "The authors developed a device to clinically measure the tibial torsion angle of different age groups. The device yields the measurement of anthropometrical variables of the distal tibia. The angular value of the tibial torsion is indirectly obtained by trigonometric calculation."


  • Reduced tibial torsion in congenital clubfoot - CT measurements in 24 patients
  • "We determined leg torsion with CT scans through the femoral condyles and the ankle joints in 24 children (17 boys) with congenital clubfoot. In 16 cases, there was a bilateral clubfoot, in 5 cases it was left-sided and in 3 cases, it was on the right side. These children were compared to 17 healthy boys and 7 girls. The ages of all children ranged between 3 and 12 years."

    T-Z

  • The effect of tibial torsion on the pathology of the knee
  • "Measurements of tibial torsion using a tropometer were made in more than 1200 consecutive patients attending an adult knee clinic. In total 1672 readings from 836 patients in 11 diagnostic categories were analysed. Patients with either patellofemoral instability or Osgood-Schlatter disease had a significant increase in lateral tibial torsion. The most important finding was a significant reduction in this torsion in patients with panarticular disease."
  • The effect of excessive tibial torsion
  • The effect of excessive tibial torsion on the capacity of muscles to extend the hip and knee during single-limb stance

    "Excessive tibial torsion, a rotational deformity about the long axis of the tibia, is common in patients with cerebral palsy who walk with a crouch gait. Previous research suggests that this deformity may contribute to crouch gait by reducing the capacity of the soleus to extend the knee; however, the effects of excess external torsion on the capacity of other muscles to extend the stance limb during walking are unknown. A computer model of the musculoskeletal system was developed to simulate a range of tibial torsion deformities. A dynamic analysis was then performed to determine the effect of these deformities on the capacity of lower limb muscles to extend the hip and knee at body positions corresponding to the single-limb stance phase of a normal gait cycle."


  • The effect of tibial torsion on the dynamic function of the soleus during gait
  • "An induced acceleration analysis (IAA) model was used to investigate the effect of tibial torsion on the ability of the soleus to support and propel the body during gait. The IAA approach is well suited for this study because it allows soleus action to be quantified in the presence of varying amounts of tibial torsion, while other factors such as body configuration and muscle activation are held constant."
  • The impact of tibial torsion measurements on gait analysis kinematics - (open access)
  • DOI: http://dx.doi.org/10.1590/1413-78522014220500579

    "Objective: To measure and compare tibial torsion values as assessed by goniometry and three-dimensional kinematics. In addition, the impact of each one of these measurements on kinematic and kinetic results for normal gait was determined.
    Conclusion: Although statistical correlation among tibial torsion angles by goniometry and three-dimensional kinematic were moderate, kinematic and kinetic analysis of the joints did not reveal any significant changes. Level of Evidence I, Diagnostic Studies - Investigating a Diagnostic Test."


  • The management of tibial torsion in patients with spina bifida
  • "We reviewed 20 patients with spina bifida who had had surgical management of tibial torsion. Eight had had bilateral procedures and 12 a unilateral procedure, giving a total of 28 limbs for analysis. We performed closed osteoclasis on seven limbs and tibial osteotomy on 21."
  • The Footprint method to assess transmalleolar axis
  • "Torsional deformities of the lower extremities are a common reason for an orthopaedic consultation and a real so part of the evaluation of a patient in gait analysis. This study assessed the level of agreement between, and the repeatability of, the Footprint method and two other methods (Prone and Jig) of measuring the transmalleolar axis (TMA) clinically. The Foot print method measures the TMA as the patients its by projecting the position of the malleoli downwards onto lined paper while the lines of the paper are aligned with the knee axis."
  • Tibial Torsion in Cerebral Palsy - Validity and Reliability of Measurement
  • "Physical examinations of tibial torsion are used for preoperative planning and to assess outcomes of tibial osteomy in patients with cerebral palsy (CP).Thethigh-foot angle (TFA) and transmalleolar axis (TMA) are commonly used, and the second toe test recently was introduced. However, the validity and reliability of the three methods have not been clarified. This study was performed to evaluate the validity and reliability of these physical measures."
  • Tibial torsion measurement by surface curvature
  • "Eighteen adult men's lower legs were scanned by a laser scanner to give the surface coordinates of the leg surfaces. By calculating curvature map so flegs from the 3D coordinates, stable anatomical landmarks such as the lateral and medial malleoli can be located. The angle indicating the degree of tibial torsion can then be derived from these landmarks."
  • Tibial torsion measured by ultrasound in children with talipes equinovarus
  • "Previous clinical studies have studied tibiofibular torsion by measuring the angular difference between a proximal (often bicondylar) plane and a distal bimaHeolar plane. We measured the angular difference between the proximal and distal posterior tibial planes as defined by ultrasound scans. We found no significant torsional difference between the right and left tibiae of 87 normal children, nor between their different age groups."