Churgay C A
University of Michigan Medical School, Ann Arbor.
Am Fam Physician. 1993 Mar;47(4):883-9.
In children, the lower extremities have extremely wide variations of normal, including calcaneovalgus foot, metatarsus adductus and flatfoot. The first two conditions often resolve or improve spontaneously over time and may be considered abnormal if they persist into adulthood. Serial casting, splints and surgery are rarely necessary. Corrective shoes, orthotic inserts and some forms of splinting have not proved to be effective. The primary care physician must establish an early and correct diagnosis, perform a general screening examination to rule out accompanying musculoskeletal deformities, assess the conditions that may become disabling and require treatment, and reassure parents and family members when observation with close follow-up is the most appropriate course of action.
在儿童中，下肢的正常形态差异极大，包括跟骨外翻足、内收跖骨和扁平足。前两种情况通常会随着时间自行缓解或改善，如果持续到成年则可能被视为异常。很少需要进行连续石膏固定、使用夹板或手术。矫正鞋、矫形鞋垫和某些形式的夹板尚未被证明有效。初级保健医生必须尽早做出正确诊断，进行全面的筛查检查以排除伴随的肌肉骨骼畸形，评估可能导致残疾并需要治疗的情况，并在密切随访观察是最合适的行动方案时安抚父母和家庭成员。
