Asymmetry of the CCD angle between left and right normal pediatric femora
Description
The caput-collum-diaphyseal (CCD) angle refers to the angle between the femoral shaft and neck and is used to diagnose conditions such as coxa vara and coxa valga, which in turn can produce gait abnormalities, hip pain, and greater potential for fracture and degenerative joint disease. The CCD is reported to change during growth and development, with the angle decreasing with age. Here, we used a sample of postmortem CT scans to assess CCD angle in 178 male and female children, aged 0 to 18 years, and assessed the effects of age and sex on the angle. Data were collected from left and right femora to also test for asymmetry in the CCD. Finally, an intraobserver analysis was conducted to help delineate true variations in angles from measurement discrepancies.
An ANCOVA run with age as a covariate revealed no significant differences between sexes (p>0.05). Age was significantly and negatively correlated with CCD angles (left r = -0.504, p = < 0.001; right r = -0.532, p = < 0.001), supporting a decrease in angles with age. A paired t-test between left and right angles did not return a significant result, indicating no systematic differences between the sides. Observed antimere variation, however, did exceed intraobserver error values, suggesting that there is some variation between left and right sides but that the deviations are more random. These data have the opportunity to serve as a baseline dataset of normal bilateral pediatric femora and has clinical relevance in terms of identifying abnormal deviations in bilateral femora.
Citation Information
Bergthold, Haley and Garvin, Heather, "Asymmetry of the CCD angle between left and right normal pediatric femora" (2026). Office of Research DMU Research Symposium. 99.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/99
Asymmetry of the CCD angle between left and right normal pediatric femora
The caput-collum-diaphyseal (CCD) angle refers to the angle between the femoral shaft and neck and is used to diagnose conditions such as coxa vara and coxa valga, which in turn can produce gait abnormalities, hip pain, and greater potential for fracture and degenerative joint disease. The CCD is reported to change during growth and development, with the angle decreasing with age. Here, we used a sample of postmortem CT scans to assess CCD angle in 178 male and female children, aged 0 to 18 years, and assessed the effects of age and sex on the angle. Data were collected from left and right femora to also test for asymmetry in the CCD. Finally, an intraobserver analysis was conducted to help delineate true variations in angles from measurement discrepancies.
An ANCOVA run with age as a covariate revealed no significant differences between sexes (p>0.05). Age was significantly and negatively correlated with CCD angles (left r = -0.504, p = < 0.001; right r = -0.532, p = < 0.001), supporting a decrease in angles with age. A paired t-test between left and right angles did not return a significant result, indicating no systematic differences between the sides. Observed antimere variation, however, did exceed intraobserver error values, suggesting that there is some variation between left and right sides but that the deviations are more random. These data have the opportunity to serve as a baseline dataset of normal bilateral pediatric femora and has clinical relevance in terms of identifying abnormal deviations in bilateral femora.
