Raney E M, Topoleski T A, Yaghoubian R, Guidera K J, Marshall J G
Shriners Hospital for Children, Tampa, Florida 33612-9499, USA.
J Pediatr Orthop. 1998 Sep-Oct;18(5):670-4. doi: 10.1097/00004694-199809000-00023.
Difficulty differentiating physiologic genu varum from early Blount's disease persists. Drennan's metaphyseal-diaphyseal (MD) angle remains the most consistently valuable radiographic parameter despite measurement error. Clinical risk factors also should be considered. All patients receiving orthoses for genu varum since 1985 were reviewed. The focus of the study was those patients with an MD angle of >16 degrees or between 9 and 16 degrees with a clinical risk factor for progression. Risk factors considered were ligamentous instability, obesity, asymmetry, and being female, black, or Hispanic. Thirty-eight patients with 60 tibiae were included. The success rate was 90%. Risk factors for failure (six cases) were instability, obesity, and delayed bracing. In cases with MD angles >16 degrees, the success rate was 86%. The results of orthotic treatment, restricted to patients meeting the stated parameters, represent improvement on the reported natural history.
区分生理性膝内翻和早期布朗特病仍然存在困难。尽管存在测量误差，但德伦南的干骺端-骨干（MD）角仍是最具一致性价值的影像学参数。临床风险因素也应予以考虑。对自1985年以来所有因膝内翻接受矫形器治疗的患者进行了回顾。该研究的重点是那些MD角大于16度或在9至16度之间且有病情进展临床风险因素的患者。所考虑的风险因素包括韧带不稳定、肥胖、不对称以及女性、黑人或西班牙裔。纳入了38例患者共60条胫骨。成功率为90%。失败的风险因素（6例）为不稳定、肥胖和支具佩戴延迟。在MD角大于16度的病例中，成功率为86%。仅限于符合所述参数患者的矫形器治疗结果表明，与所报道的自然病程相比有所改善。
