Bruce R W
Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Pediatr Clin North Am. 1996 Aug;43(4):867-81. doi: 10.1016/s0031-3955(05)70439-9.
A general understanding of the cause and natural history of rotational and angular malalignment of the lower extremity allows accurate differentiation between pathologic and physiologic conditions. One can then educate the involved and often concerned family and proceed with observational management of physiologic conditions as spontaneous improvement of alignment can be expected. Aside from treatment for resistant metatarsus adductus, other forms of treatment, such as special shoes, casts, or braces, are rarely beneficial and have no proven efficacy. Persistent deformity beyond skeletal maturity is unusual and rarely causes significant functional disability. In rare cases of severe residual deformity, operative correction is the only effective treatment.
对下肢旋转和角向畸形的病因及自然病程有全面的了解，有助于准确区分病理状况和生理状况。这样就可以对相关且通常忧心忡忡的家庭进行教育，并对生理状况进行观察性管理，因为预计对线会自发改善。除了治疗难治性内收足，其他治疗方式，如特殊鞋子、石膏或支具，很少有益且未证实有疗效。骨骼成熟后仍持续存在的畸形并不常见，很少导致严重的功能残疾。在极少数严重残留畸形的情况下，手术矫正才是唯一有效的治疗方法。
