The Art of Limb Alignment [3 ed.]

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The Art of Limb Alignment [3 ed.]

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Shawn C. Standard
John E. Herzenberg
Janet D. Conway
Noman A. Siddiqui

Citation preview

Normal Limb Alignment

mechanical axis is medial to the center of the knee joint, it is called varus (Fig. 28). Normal MAD falls within 3 mm medial and 3 mm lateral of the center of the knee. Which factors contribute to the mechanical alignment? The mechanical alignment of the lower limb is formed by the additive effects of the shape of the femur and tibia and by the joint alignment of the hip, knee, and ankle. The femur and tibia each have a mechanical axis and an anatomic axis. The hip, knee, and ankle each have a joint line that represents the plane of that joint in space.

Chapter 1

The intersection of the joint line and the femoral or tibial axis (mechanical or anatomic) forms a joint angle. These joint angles are the major factors that determine the overall alignment of the lower limb. After you determine these angles, you can conduct a detailed analysis of limb alignment. The mechanical axis of a bone segment is defined as a straight line connecting the center of the proximal joint to the center of the distal joint (Fig. 3). The mechanical axis of the bone is always a straight line. The anatomic axis of a bone segment is defined as the mid-diaphyseal line of the bone. The anatomic

Fig. 4: The anatomic axis on an AP view x-ray can either be straight (A and B) or curved (C and D) depending on the shape of the bone.

© 20 7 4 Sinai Hospital of Baltimore

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