Wilkins K E
Pediatr Clin North Am. 1986 Dec;33(6):1429-38. doi: 10.1016/s0031-3955(16)36152-1.
The bowed appearance of the lower extremities is most often caused by internal rotation of the tibia in relationship to the femur. It is most commonly seen as the infant commences ambulation. This so-called physiologic bowing usually spontaneously resolves with growth and the maturity of the lower extremities. In older children, tibia varum may occur, in which there is a local arrest of growth on the posterior medial aspect of the tibia producing a true structural angulation. In certain long-standing metabolic or genetic bone disorders, the effects of weight bearing produce a true bowing of the extremities with changes about the hips, knees, and ankles. The most important aspect in the evaluation of a child with a bowed appearance of the lower extremities is to determine which conditions require aggressive treatment and which ones require simply giving the parents reassurance that the condition will spontaneously regress.
下肢呈弓形外观最常见的原因是胫骨相对于股骨向内旋转。这种情况在婴儿开始行走时最为常见。这种所谓的生理性弓形通常会随着下肢的生长和成熟而自行消退。在年龄较大的儿童中，可能会出现胫骨内翻，即胫骨后内侧局部生长停滞，导致真正的结构性成角。在某些长期的代谢性或遗传性骨病中，负重的影响会导致四肢真正的弓形，并伴有髋部、膝部和踝部的变化。评估下肢呈弓形外观的儿童时，最重要的方面是确定哪些情况需要积极治疗，哪些情况只需让家长放心，该病症会自行消退。
