Influence of muscle groups' activation on proximal femoral growth tendency

Muscle and joint contact force influence stresses at the proximal growth plate of the femur and thus bone growth, affecting the neck shaft angle (NSA) and femoral anteversion (FA). This study aims to illustrate how different muscle groups' activation during gait affects NSA and FA development in able-bodied children. Subject-specific femur models were developed for three able-bodied children (ages 6, 7, and 11 years) using magnetic resonance images. Contributions of different muscle groups-hip flexors, hip extensors, hip adductors, hip abductors, and knee extensors-to overall hip contact force were computed. Specific growth rate for the growth plate was computed, and the growth was simulated in the principal stress direction at each element in the growth front. The predicted growth indicated decreased NSA and FA (of about over a four-month period) for able-bodied children. Hip abductors contributed the most, and hip adductors, the least, to growth rate. All muscles groups contributed to a decrease in predicted NSA (similar to 0.01 degrees-0.04 degrees and FA (similar to 0.004 degrees-0.2 degrees), except hip extensors and hip adductors, which showed a tendency to increase the FA (similar to 0.004 degrees-0.2 degrees). Understanding influences of different muscle groups on long bone growth tendency can help in treatment planning for growing children with affected gait.