Gould N, Moreland M, Alvarez R, Trevino S, Fenwick J
University of Vermont, College of Medicine, Burlington 05405.
Foot Ankle. 1989 Apr;9(5):241-5. doi: 10.1177/107110078900900506.
The purposes of the project were to monitor the development of the lower extremities and the longitudinal arch of the foot and to determine whether or not arch support footwear (three types) affected development of a neutral arch in toddlers 11 to 14 months of age until age 5 years. A total of 125 beginner walkers were recruited through the pediatrics department during a period of 1 1/2 years and divided by lot into four different footwear groups (one nonarch supportive). The group was studied for 4 years by physical examinations, x-ray films, and pedotopography (a Moire fringe technique of photography). At initial examination all of the apparently normal toddlers had pes planus by all clinical, roentgenographic, and photographic measurements. There were no cavus feet at that time or at 5 years of age. Arches developed regardless of the footwear worn but development was faster during the first 2 years (until age 3 years) with arch support footwear. The rapidity of arch development until 5 years of age continued in those children who wore longitudinal arch cookies. Ossification of the sustentaculum tali begins at approximately 5 years of age but is not complete for at least another 1 to 2 years. Hyperpronation was present in 77.9% and genu valgum in 92.3% of the 5-year-old children. These conditions are apparently the norm at this age in both boys and girls.
该项目的目的是监测下肢和足纵弓的发育情况，并确定足弓支撑鞋（三种类型）是否会影响11至14个月大的学步幼儿直至5岁时中性足弓的发育。在1年半的时间里，通过儿科招募了总共125名刚开始学步的儿童，并随机分为四个不同的鞋类组（一组无足弓支撑）。通过体格检查、X光片和足底地形图（一种莫尔条纹摄影技术）对该组儿童进行了4年的研究。在初次检查时，所有表面上正常的学步幼儿通过所有临床、影像学和摄影测量均显示扁平足。当时以及5岁时均没有高弓足。无论穿着何种鞋类，足弓都会发育，但在头两年（直至3岁），穿着足弓支撑鞋时足弓发育更快。那些穿着纵弓鞋垫的儿童直至5岁时足弓发育速度仍持续较快。跟骨载距突的骨化大约在5岁时开始，但至少还需要1至2年才能完成。5岁儿童中，77.9%存在过度内旋，92.3%存在膝外翻。显然，在这个年龄段，这些情况在男孩和女孩中都很常见。
