Krishna M, Evans R, Sprigg A, Taylor J F, Theis J C
Alder Hey Children's Hospital, Liverpool, England.
J Bone Joint Surg Br. 1991 Mar;73(2):207-10. doi: 10.1302/0301-620X.73B2.2005140.
Previous clinical studies have studied tibiofibular torsion by measuring the angular difference between a proximal (often bicondylar) plane and a distal bimalleolar plane. We measured the angular difference between the proximal and distal posterior tibial planes as defined by ultrasound scans. We found no significant torsional difference between the right and left tibiae of 87 normal children, nor between their different age groups. The mean external torsion of 58 legs with congenital talipes equinovarus was 18 degrees; significantly less than the mean 40 degrees in the normal children and 27 degrees in the clinically normal legs of the 22 patients with unilateral congenital talipes equinovarus. We did not confirm the previously reported increase in external torsion with increasing age. The relative internal tibial torsion we have demonstrated in patients with congenital talipes equinovarus must be differentiated from the posterior displacement of the distal fibula observed by others and which may result from manipulative treatment. The relative internal tibial torsion we found in the clinically normal legs of children with congenital talipes equinovarus is further evidence that in this condition the pathology is not confined to the clinically affected foot.
以往的临床研究通过测量近端（通常为双髁）平面与远端双踝平面之间的角度差异来研究胫腓骨扭转。我们通过超声扫描测量了近端和远端胫骨后平面之间的角度差异。我们发现，87名正常儿童的左右胫骨之间，以及不同年龄组之间，均未发现明显的扭转差异。58例先天性马蹄内翻足患儿的平均外旋角度为18度；明显低于正常儿童的平均40度，以及22例单侧先天性马蹄内翻足患儿临床正常下肢的平均27度。我们并未证实先前报道的随着年龄增长外旋增加的情况。我们在先天性马蹄内翻足患者中所证实的相对胫骨内旋，必须与其他人观察到的远端腓骨后移相区分，后者可能是手法治疗的结果。我们在先天性马蹄内翻足患儿临床正常下肢中发现的相对胫骨内旋，进一步证明了在这种情况下，病变并不局限于临床受累的足部。
