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Breech presentation is a risk factor for dysplasia of the femoral trochlea.

Øye CR, Foss OA, Holen KJ - Acta Orthop (2015)

Bottom Line: The way of fetal presentation at birth and standard parameters such as sex, gestational age, and length and weight at birth were registered.The incidence of breech position in these children was 15-fold higher.For some newborns, a high sulcus angle can be found at birth, indicating that trochlear dysplasia can be found from birth.

View Article: PubMed Central - PubMed

Affiliation: a Department of Orthopaedic Surgery , Trondheim University Hospital , Trondheim , Norway.

ABSTRACT

Background and purpose: Instability of the patellofemoral joint is a common disorder in children and young adults. Although it has multifactorial causes, a shallow femoral trochlea is the single most important factor for instability. There is no consensus as to the etiology of trochlear dysplasia. We assessed whether the presentation of the fetus at birth could be a predisposing factor for trochlear dysplasia.

Subjects and methods: We examined 348 knees in 174 newborns using ultrasonography, concentrating especially on the trochlea femoris. We measured the sulcus angle (SA) on a transverse scan. The way of fetal presentation at birth and standard parameters such as sex, gestational age, and length and weight at birth were registered. As breech presentation is a known risk factor for dysplasia of the hip, we also looked for an association between dysplasia of the femoral trochlea and dysplasia of the hips.

Results: The mean SA was 148°. 17 knees in 14 children had an SA of >159°, which was defined as the threshold value for dysplasia. The incidence of breech position in these children was 15-fold higher. Of the different groups of breech positions, a child in frank breech with the knees locked in extension had a 45-fold increased risk of having trochlear dysplasia.

Interpretation: For some newborns, a high sulcus angle can be found at birth, indicating that trochlear dysplasia can be found from birth. Breech presentation with knees extended appears to be a major risk factor for development of trochlear dysplasia.

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The different categories of breech position. Complete breechis where the knees are held in a fixed flexed position. Incomplete breech is where one knee is kept flexed while the other is extended. The most frequent type is the frank breech position, where the knees are fixed extended while the hips are flexed.
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Figure 0002: The different categories of breech position. Complete breechis where the knees are held in a fixed flexed position. Incomplete breech is where one knee is kept flexed while the other is extended. The most frequent type is the frank breech position, where the knees are fixed extended while the hips are flexed.

Mentions: From 28–30 weeks’ gestation, the position of the fetus is in one of these categories: cephalic, breech, or transverse. We categorized the presentation of the fetus at birth as cephalic, breech, or transverse/unknown. Breech position was further categorized into complete, incomplete, or frank (Figure 2).Figure 2.


Breech presentation is a risk factor for dysplasia of the femoral trochlea.

Øye CR, Foss OA, Holen KJ - Acta Orthop (2015)

The different categories of breech position. Complete breechis where the knees are held in a fixed flexed position. Incomplete breech is where one knee is kept flexed while the other is extended. The most frequent type is the frank breech position, where the knees are fixed extended while the hips are flexed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940585&req=5

Figure 0002: The different categories of breech position. Complete breechis where the knees are held in a fixed flexed position. Incomplete breech is where one knee is kept flexed while the other is extended. The most frequent type is the frank breech position, where the knees are fixed extended while the hips are flexed.
Mentions: From 28–30 weeks’ gestation, the position of the fetus is in one of these categories: cephalic, breech, or transverse. We categorized the presentation of the fetus at birth as cephalic, breech, or transverse/unknown. Breech position was further categorized into complete, incomplete, or frank (Figure 2).Figure 2.

Bottom Line: The way of fetal presentation at birth and standard parameters such as sex, gestational age, and length and weight at birth were registered.The incidence of breech position in these children was 15-fold higher.For some newborns, a high sulcus angle can be found at birth, indicating that trochlear dysplasia can be found from birth.

View Article: PubMed Central - PubMed

Affiliation: a Department of Orthopaedic Surgery , Trondheim University Hospital , Trondheim , Norway.

ABSTRACT

Background and purpose: Instability of the patellofemoral joint is a common disorder in children and young adults. Although it has multifactorial causes, a shallow femoral trochlea is the single most important factor for instability. There is no consensus as to the etiology of trochlear dysplasia. We assessed whether the presentation of the fetus at birth could be a predisposing factor for trochlear dysplasia.

Subjects and methods: We examined 348 knees in 174 newborns using ultrasonography, concentrating especially on the trochlea femoris. We measured the sulcus angle (SA) on a transverse scan. The way of fetal presentation at birth and standard parameters such as sex, gestational age, and length and weight at birth were registered. As breech presentation is a known risk factor for dysplasia of the hip, we also looked for an association between dysplasia of the femoral trochlea and dysplasia of the hips.

Results: The mean SA was 148°. 17 knees in 14 children had an SA of >159°, which was defined as the threshold value for dysplasia. The incidence of breech position in these children was 15-fold higher. Of the different groups of breech positions, a child in frank breech with the knees locked in extension had a 45-fold increased risk of having trochlear dysplasia.

Interpretation: For some newborns, a high sulcus angle can be found at birth, indicating that trochlear dysplasia can be found from birth. Breech presentation with knees extended appears to be a major risk factor for development of trochlear dysplasia.

Show MeSH
Related in: MedlinePlus