Robertson W W, Corbett D
Department of Orthopaedic Surgery, Children's National Medical Center, Washington, DC 20010, USA.
Clin Orthop Relat Res. 1997 May(338):14-8. doi: 10.1097/00003086-199705000-00004.
The medical records of 330 children who were born with uncomplicated congenital clubfoot were reviewed retrospectively. To determine their months of conception, the duration of gestation was extrapolated and those which were less than 40 weeks were noted. The years of conception for the studied children were from 1956 to 1994. Months of the year were ascribed angle values and the distribution of conceptions per month were grouped in radial manner. Using a circular analysis for variance a lack of uniform circular distribution was found for the grouped months of conception. There is a significant seasonal variation in the data. The mean month of conception was June. This finding is at variance with the peak months of conception for the population of the United States for the years 1989 through 1993. The theory that congenital clubfoot is caused by an intrauterine Enterovirus may be supported by this data. The summer and fall peak of Enterovirus infections in temperate climates coincide with the stage of embryologic development (> 8 weeks) which would allow an anterior horn cell lesion to lead to a deformity such as congenital club foot.
对330例出生时患有单纯性先天性马蹄内翻足的儿童病历进行了回顾性研究。为确定其受孕月份，推算孕期时长，并记录孕期少于40周的情况。所研究儿童的受孕年份为1956年至1994年。将一年中的月份赋予角度值，并以径向方式对每月受孕分布进行分组。通过圆方差分析发现，受孕月份分组缺乏均匀的圆形分布。数据存在显著的季节性变化。受孕的平均月份为6月。这一发现与1989年至1993年美国人群的受孕高峰月份不同。先天性马蹄内翻足由子宫内肠道病毒引起的理论可能得到这一数据的支持。在温带气候中，肠道病毒感染的夏秋高峰与胚胎发育阶段（>8周）相吻合，这可能使前角细胞损伤导致先天性马蹄内翻足等畸形。
