Frontal Plane Angular Knee Deformities in Schoolchildren in Kribi, South Region of Cameroon

Volume 9 | Issue 1 | January-April 2023 | Page: 00-00 | Jean Gustave Tsiagadigui, Robinson Mbako Ateh, Marie-Ange Ngo Yamben, Franck Olivier Ngongang, Daniel Handy Eone, Maurice Aurelien Sosso


Authors: Jean GustaveTsiagadigui [1, 3] MD, PhD, Robinson Mbako Ateh [2] MD, Marie-Ange Ngo Yamben [1] MD, Franck Olivier Ngongang [1] MD, Daniel Handy Eone [1] MD, Maurice Aurelien Sosso [1] MD

[1] Department of Surgery and Specialties of Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, BP 1364, Yaoundé, Cameroon
[2] Faculty of Medicine and Pharmaceutical Sciences of the University of Douala, BP 2701, Douala, Littoral Region, Cameroon.
[3] Department of Mechanical Engineering, ENSET, University of Douala, BP 2701, Douala, Littoral Region, Cameroon.

Address of Correspondence

Dr. Jean GustaveTsiagadigui,
Department of Surgery and Specialties of Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, BP 1364, Yaoundé, Cameroon.


Bone problems such as angular deformities of the knee are common in children in Africa. The aim of this survey was to study epidemiologic aspects of frontal plane angular knee deformities in school children in Kribi. A total of 860 school children in Kribi aged 3 to 18 years were surveyed in a cross-sectional descriptive study from December 2019 to March 2020. Each child was examined. Intercodylar distances, intermalleolar distances and the tibiofemoral angles were assessed. The type of knee deformity in the frontal plane was determined from the children`s tibiofemoral angles and compared with reference values of normal children in the same age ranges. One hundred and fourty two (142, 16.5%) children surveyed presented with frontal plane knee deformities, with genu varum representing 68.0% (96 cases) of the deformities. The prevalence of these deformities in school children in Kribi varied significantly with age. We did not find any significant difference in the variation of these deformities with gender or ethnic groups. We identified some frontal plane angular knee deformities, including bilateral deformities being predominant 90.71% (127 cases). The mean body mass index was higher than those of normal children. 15.5% (22) of them presented with associated deformity in the sagital plane, dominated by bilateral genu recurvatum and 33.8% (48) of them presented with associated rotational knee deformities, dominated by bilateral medial rotation. Frontal plane knee angular deformities are common amongst school children in Kribi. Their prevalence is 16.51% (142 cases). This prevalence varies with ages. Sagittal plane and rotational plane deformities are equally present in children presenting with these deformities.
Keywords: Bone, Children, Deformities, Cameroon.


[1] Ezeuko VC, Owah S, Ukoima HS, Ejimofor OC, Aligwekwe AU, Bankole L. Clinical study of the chronological changes in knee alignment pattern in normal south-east nigerian children aged between 0 and 5 years. Electron J Biomed. 2010;1:16–21.
[2] Gale Group. Knee deformities. Gale Encyclopedia of Medecine. The Gale Group; 2008.
[3] Houghton Mifflin Company. Genu varum. The American Heritage Medical Dictionary. Houghton Mifflin Company; 2007.
[4] Mathew SE, Madhuri V. Clinical tibiofemoral angle in south Indian children. Bone Jt Res. 2013 Aug;2(8):155–61.
[5] George HT. Angular deformities of the lower extremities in children. Chapman’s Orthopaedic Surgery. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 4288–326.
[6] Cahuzac JP, Vardron D, Sales J. Development of the clinical tibiofemoral angle in normal adolescents: a study of 427 normal subjects from 10 to 16 years of age. J Bone Jt Surg. 1995 Sep;77B(5):729–32.
[7] Salenius P, Vankka E. The Development of the Tibio-femoral Angle in Children. J Bone Jt Surg. 1975;(57 A):259–61.
[8] Samia AA , Wafa BA. Normal Development of the Tibiofemoral Angle in Saudi Children from 2 to 12 Years of Age. World Appl Sci J. 2011;12(8):1353–61.
[9] Mahmoud KM, Alireza K, Zahra Y. The prevalence of genu varum and genu valgum in primary school children in Iran 2003-2004. J Med Sci. 2005;5:52–4.
[10] Heath CH, Staheli LT Normal limits of knee angle in white children genu varum and genu valgum. J Pediatr Orthop. 1993;(13):259–62.
[11] Cheng JC, Chan PS, Chiang SC, Hui PW. Angular and rotational profile of the lower limb in 2,630 Chinese children. J Pediatr Orthop. 1991 Apr;11(2):154–61.
[12] Ibrahima F, Pisoh T, Abolo ML, Sosso MA, Malonga EE. Déformations angulaires de genu varum/genu valgum chez l’enfant et l’adulte jeune : Revue préliminaire de 158 cas observés à Yaoundé. Médecine Afr Noire. 2002;49(4):169–75.
[13] Udoaka AI, Olotu J, Oladipo GS. The Prevalence of Genu Varum in Primary School Children in Port Harcourt, Nigeria. Sci Afr. 2012 Dec;11(2):115–7.
[14] Oginni LM, Badru OS, Sharp CA, Davie MW, Worsfold M. Knee angles and rickets in Nigerian children. J Pediatr Orthop. 2004;24:403–7.
[15] Singh O, Maheshwari TP, Hasan S, Ghatak S, Ramphal SK. A study of Tibiofemoral angle among Healthy Male Maharashtrian population. Int J Biomed Res. 2013;4(7):323–9.
[16] Ramin E, Seyed MM, Taghi B. Angular Deformities of the Lower Limb in Children. Asian J Sports Med. 2010 Mar;1(1):46–53.
[17] Sharrard WJ. Knock knees and bow legs. Br Med J. 1976;1:826–7.
[18] Mehmet A, Tunc¸ OC, Recep M. Normal Development of the Tibiofemoral Angle in Children: A Clinical Study of 590 Normal Subjects From 3 to 17 Years of Age. J Pediatr Orthop. 2001;21(2):264–7.
[19] Engel GM, Staheli LT. The natural history of torsion and other factors influencing gait in childhood. Clin Orthop. 1974;991:12–7.
[20] Thacher TD, Fischer PR, Tebben PJ, Ravinder J Singh, Cha SS, Maxson JA, et al. Increasing incidence of nutritional rickets: a population-based study in Olmsted County, Minnesota. Mayo Clinic Proceedings [Internet]. Elsevier; 2013.
[21] Echarrri JJ, Bazeboso JA, Gullen GF. Rachitic deformities of lower members in congolese children. An Sist Sanit Navar. 2008 Sep;31(3):235–40.
[22] Ahmed S. Methods in sample survey: Cluster Sampling. Johns Hopkins Bloomberg School of Public Health; 2009.
[23] William C. Sampling Techniques. 3rd Edition. New York: John Wiley & Sons; 1977. 233-290 p.
[24] Ross K. Sample design for educational survey research. Quantitative research methods in educational planning [Internet]. Paris, France: International Institute for Educational Planning/UNESCO; 2005. p. 17–25.
[25] Naing L, Winn T, Rusli B. Practical Issues in Calculating the Sample Size for Prevalence Studies. Arch Orofac Sci. 2006;1:9–14.
[26] Yoo JH, Cho TJ, Chung CY, Yoo WJ. Development of tibiofemoral angle in Korean children. J Korean Med Sci. 2008;23:714–7.
[27] Omololu B, Tella A, Ogunlade SO, Adeyemo AA, Adebisi A, Alonge TO, et al. Normal values of knee angle, intercondylar and intermalleolar distances in Nigerian children. West Afr J Med. 2003;22:301–4.
[28] Qureshi MA, Soomro MB, Jokhio IA. Normal limits of knee angle in Pakistani children. Prof Med J. 2000;7:221–6.
[29] Rahmani NF, Daneshmandi H, Irandoust KH. Prevalence of Genu Valgum in Obese and Underweight Girls. World J Sport Sci. 2008;1(1):27–31.
[30] Ibrahima F, Bernadette NN, Bahebeck J. A study of 2711 cases observed at the National Centre for the Rehabilitation of the Disabled of Yaoundé (Cameroon). Oral presentation presented at: Socot; 2014; Brazil.

How to Cite this Article: Tsiagadigui JG, Ateh RM, Yamben MAN, Ngongang FO, Eone DH, Sosso MA | Frontal Plane Angular Knee Deformities in School Children in Kribi, South Region of Cameroon | International Journal of Paediatric Orthopaedics | January-April 2023; 9(1): 00-00 |

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