Lincoln Todd L, Suen Patrick W
Department of Orthopaedic Surgery, Stanford University Medical Center, Lucile Salter Packard Children's Hospital, Palo Alto, CA, USA.
J Am Acad Orthop Surg. 2003 Sep-Oct;11(5):312-20. doi: 10.5435/00124635-200309000-00004.
Most rotational variations in young children, such as in-toeing, out-toeing, and torticollis, are benign and resolve spontaneously. Understanding the normal variations in otherwise healthy children is vital to identifying true structural abnormalities that require intervention. A deliberate assessment of the rotational profile is necessary when evaluating children who in-toe or out-toe. In-toeing is usually attributable to metatarsus adductus in the infant, internal tibial torsion in the toddler, and femoral anteversion in children younger than 10 years. Out-toeing patterns largely result from external rotation hip contracture, external tibial torsion, and external femoral torsion. Although congenital muscular torticollis is the most common explanation for the atypical head posture in children, more serious disorders, including osseous malformations, inflammation, and neurogenic disorders, should be excluded.
幼儿的大多数旋转变化，如内八字、外八字和斜颈，都是良性的，会自行缓解。了解健康儿童的正常变化对于识别需要干预的真正结构异常至关重要。在评估内八字或外八字的儿童时，有必要对旋转情况进行仔细评估。内八字通常归因于婴儿期的内收足、幼儿期的胫骨内旋以及10岁以下儿童的股骨前倾。外八字模式主要由髋关节外旋挛缩、胫骨外旋和股骨外旋引起。虽然先天性肌性斜颈是儿童非典型头部姿势最常见的原因，但应排除更严重的疾病，包括骨畸形、炎症和神经源性疾病。
