Emco Clinic Bad Dürrnberg, Prof Martin Hell Str 7-9, 5422 Bad Dürrnberg, Austria.
BMC Musculoskelet Disord. 2009 Dec 17;10:159. doi: 10.1186/1471-2474-10-159.
Wearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux.
858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes) were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio) for a hallux angle > or = 4 degrees was calculated.
Exact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position) at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet.88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio) of a lateral hallux deviation of > or = 4 degrees in children wearing shoes of insufficient length was significantly increased.
There is a significant relationship between the hallux angle in children and footwear that is too short in length. The fact that the majority of the children examined were wearing shoes of insufficient length makes the issue particularly significant. Our results emphasize the importance of ensuring that children's footwear fits properly.
儿童期穿着长度不足的鞋子常常被认为会导致足部畸形，特别是导致拇外翻畸形。到目前为止，这些假设尚未通过科学研究得到证实。本研究旨在调查这种关联是否可以通过统计学证明，以及穿着长度不足鞋子的儿童实际上是否确实有更大的风险出现拇趾更明显的侧向偏斜。
本研究纳入了 858 名学龄前儿童。研究样本按性别、城乡地区和奥地利省份进行分层。记录拇趾角度和足部长度。评估儿童鞋（幼儿园室内鞋和户外鞋）的内长。采集个人数据和不同的人体测量数据。通过逐步逻辑回归分析对拇外翻偏差风险进行统计学检验，并计算拇趾角度>或=4 度的相对风险（比值比）。
总共对 1579 只个体足进行了精确的拇趾角度检查。在 1579 只足中，只有 23.9%呈现出大脚趾的直位。其余的则表现出不同程度的侧向偏斜（外翻位），其中 14.2%的儿童足的大脚趾偏斜角度等于或大于 10 度。在接受检查的 808 名儿童中，88.8%穿着室内鞋长度不足，在 812 名穿着户外鞋的儿童中，有 69.4%的鞋子过短。鞋的长度适配与拇趾角度之间存在显著关系：鞋子越短，拇趾角度的值越高。穿着长度不足的鞋子的儿童出现>或=4 度的侧向拇趾偏斜的相对风险（比值比）显著增加。
儿童的拇趾角度与鞋子过短之间存在显著关系。事实上，大多数接受检查的儿童都穿着长度不足的鞋子，这使得问题更加突出。我们的研究结果强调了确保儿童鞋适当合脚的重要性。
