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The angle of convergence of the femora is a major factor in determining the femoral-tibial angle. In human females the femora converge more than in males because the pelvic bone is wider in females. In the condition genu valgum the femurs converge so much that the knees touch one another. The opposite extreme is genu varum (bow-leggedness)
Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [1] especially in the femur and tibial bones, but can also occur genetically at birth.
While maintaining internal rotation, a valgus force is applied to the knee while it is slowly flexed. If the tibia's position on the femur reduces as the knee is flexed in the range of 30 to 40 degrees or if there is an anterior subluxation felt during extension the test is positive for instability. Pivot-shift is not straightforward to perform.
Lateral rotation of tibia- tight biceps femoris; The hip flexion contracture is physiologic in the first 3 months of life and if it is absent in this period it may be a sign of developmental dysplasia of the hip. It is used to identify unilateral fixed flexion deformity of the hip. [3]
Similar to anterior drawer test, the knee should be flexed 90 degrees and the tibia is pushed backwards. If the tibia can be pushed posteriorly, then the posterior drawer test is positive. In tibial sag test, both knees are flexed at 90 degrees with the person in supine position and bilateral feet touching the bed.
Various measuring points for these have been suggested, but a functional method is to measure the distances between joint surfaces: [4] Femur length: The superior aspect of the femoral head and the distal portion of the medial femoral condyle. Tibial length: The medial tibial plateau and the tibial plafond
Exercises should strengthen quadriceps muscles such as rectus femoris, vastus intermedius, and vastus lateralis. However, tight and strong lateral quadriceps can be an underlying cause of patellar dislocation. If this is the case, it is advisable to strengthen the medial quadriceps, vastus medialis (VMO), and stretch the lateral muscles. [17]
The popliteus assists in flexing the leg upon the thigh; when the leg is flexed, it will rotate the tibia inward. It is especially called into action at the beginning of the act of bending the knee, in as much as it produces the slight inward rotation of the tibia, which is essential in the early stage of this movement. [6]