Killam P E
Childrens Hospital, Los Angeles, Calif.
Nurse Pract. 1989 Jul;14(7):27-30, 32-4, 36.
Parents often seek orthopedic evaluation of their young children because of apparent abnormalities. However, many of these are simply developmental variations that are part of normal growth and development. Pes planus, or flat foot, is one of the earliest and most common concerns. Torsional variations are also often seen; the presenting complaint may be intoeing (metatarsus adductus, tibial torsion and increased femoral anteversion) or out-toeing (pes calcaneovalgus and external rotation contractures of the hips). Angular variations (genu varum and genu valgum) are also seen frequently in young children. In assessing each finding, consideration must be given to the age at which the finding may be considered within normal limits, methods of examination and documentation, the expected course, findings that may signify abnormality, and appropriate follow-up and referral. An understanding of these common developmental variations in the orthopedic assessment of young children will enable the health care provider to respond to parents' concerns with accurate information and counseling.
由于明显的异常情况，家长们常常会带年幼的孩子去接受骨科评估。然而，其中许多情况仅仅是发育变异，是正常生长发育的一部分。扁平足是最早且最常见的问题之一。扭转变异也经常出现；就诊主诉可能是内翻足（跖骨内收、胫骨扭转和股骨前倾增加）或外翻足（跟骨外翻和髋关节外旋挛缩）。角状变异（膝内翻和膝外翻）在幼儿中也很常见。在评估每一项检查结果时，必须考虑该结果在正常范围内的年龄、检查和记录方法、预期病程、可能表明异常的结果以及适当的随访和转诊。了解这些幼儿骨科评估中常见的发育变异，将使医疗保健提供者能够用准确的信息和咨询回应家长的担忧。
