Hensinger R N
Postgrad Med. 1976 Oct;60(4):161-7. doi: 10.1080/00325481.1976.11714453.
Rotational abnormalities in the lower extremities are common in the growing child, but they seldom represent any serious handicap in adult life. When confronted with such a problem, the physician should carefully rule out any underlying pathologic abnormality and should approach the problem in a step-wise fashion. The component parts of the lower extremity should be examined carefully and individually to assess their role in the rotational problem. The usual causes of internal rotation problems, or toeing in, are metatarsus adductus, internal tibial torsion, and femoral anteversion. External rotation problems are infrequent and pose fewer problems. These include calcaneovalgus, external rotation of the tibia, and external rotatory contractures of the lower extremity. The natural history of these conditions favors improvement with time. However, some patients may require conservative treatment, such as stretching and splints. Rarely, a patient may require surgical intervention.
下肢旋转异常在成长中的儿童中很常见，但在成年后很少会造成严重的功能障碍。当面对这样的问题时，医生应仔细排除任何潜在的病理异常，并应逐步解决该问题。应仔细并分别检查下肢的各个组成部分，以评估它们在旋转问题中所起的作用。内旋问题（即脚尖内扣）的常见原因是内收型扁平足、胫骨内扭转和股骨前倾。外旋问题较少见，且问题也较少。这些包括跟骨外翻、胫骨外旋和下肢外旋挛缩。这些情况的自然病程倾向于随时间改善。然而，一些患者可能需要保守治疗，如拉伸和使用夹板。极少数情况下，患者可能需要手术干预。
