Objective To analyze the relationship between skeletal development and gait problems of lower limbs in children aged 1~5 years,in order to provide pediatric clinicians with evidence for early diagnosis and intervention.Methods A total of 741 children were randomly selected from January 2012 to December 2016 in Nanjing Maternal and Child Health Care Outpatient. Gait, Q angle, lower extremity ankle distance,lower extremity rotation and lower limb angle were measured. Results 1)There were statistically significant differences in Q angle and ankle distance among children of different age groups(F=51.28、11.27,P<0.05). 2)Q angle continued to increase with age, reaching a peak at four years old, and then the Q angle decreased.There was no gender difference in Q angle trend between 1~5 years.3)In children with physiological knee valgus, flat feet, foot overpronation,foot pronation of these lower limb development problems,Q angle and ankle distance values were generally larger(P<0.05).Conclusions It is a dynamic change process in the change of 1 to 5-year-old children quadriceps muscle angle,lower extremity ankle distance,and it shows the first increase with age and then reduces the law ; Q angle and ankle distance values are too larger in children with physiological knee valgus,flat feet,foot overpronation,foot pronation of these lower limb gait problems.
Key words
children′s lower limb skeletal development /
gait analysis /
Q angle /
ankle distance /
physiological knee valgus /
alignmentfeet /
overpronation
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References
[1] 胡祖杰, 刘传康.儿童X型腿、O型腿的评估与治疗进展[J].现代医药卫生,2013,29(10):1512-1513.
[2] 胡燕, 黎海茂.儿童下肢“弯曲”的评估与处理[J].中国当代儿科杂志,2011,13(11):851-854.
[3] 杨平,蔡丽飞.足过度旋前对人体力线的影响及治疗方法[J].中国康复理论与实践 ,2016 22(1):73-74.
[4] Neal BS, Griffiths IB, Dowling GJ, et al. Static foot posture as ariskfactor for lower limb overuse injury: a systematic review and meta-analysis[J]. J Foot Ankle Res, 2014, 7(1): 55-56.
[5] 张奉琪,王慧娟,张奇,等.跟骨内移截骨治疗获得性扁平足临床分析[J]. 中国矫形外科杂志,2011.19(3):192-194.
[6] 燕晓宇, 俞光荣.正常足弓的维持及临床意义[J].中国临床解剖杂志,2005, 2(2):219-221.
[7] 王亭,王继松,李静,等.无症状扁平足与正常足的足底压力和足弓形态对比研究[J].中国临床解剖学杂志,2011,29(2):217-221.
[8] 安丙辰,戴尅戎.影响膝骨关节炎发病及进展的生物力学因素[J].国际骨科学杂志,2012,33(3):153-156.
[9] Segal NA, Glass NA,Torner J ,et al.Quadriceps weakness predicts risk forknee joint space narrowing in women in the MOST cohort[J]. Osteoarthritis Cartilage, 2010,18(6):769-755.
[10] 邱玲, 郑旭.Q角的理论与临床应用思考[J].中国康复,2009,24(4):275-276.
[11] 陈世益,范振华,许胜文,等.排球运动员髌骨软骨软化症与角关系的研究临床流行病学研究[J].中国运动医学杂志,1991,10(4):193-198.
[12] 吴胜兰, 郝建民.小儿“X”“O”型腿矫正的临床疗效分析报道[J].中国医药指南,2013, 11(28):299-301.
[13] Staheli LT,Corbett M,Wyss C,et al.Lower-extremity rotational problems in children Normal values to guide management[J].J Bone Joint Surg Am, 1985, 67(1):39-47.
[14] Najjarine A, Pod-NSW D.Finding NCSP using the NAS anterior linesmethod [J]. Super Biomech Newsl, 2012,17(1):1-2.
[15] 张丽华,回俊岭,陈树君,等. 沧州市1 629名儿童青少年足弓发育状况[J].中国学校卫生,2007,28(6):532-533.
[16] 谷惠儒, 李立峰.股四头肌角的测量及其影响因素[C].中国生物医学工程进展—2007中国生物医学工程联合学术年会论文集(下册):西安:西安交通大学出版社,2007:1579-1580.
[17] Rodrigues P, Chang R, Ten Broek T, et al.Evaluating the coupling between foot pronation and tibial internal rotation continuously using vector coding[J].J Appl Biomech,2015,31(2):88-94.
[18] 王志杰,陈游,李安平,等. 不同状态下 Q 角对复发性髌骨脱位的临床意义[J]. 中国修复重建外科杂志,2014,28(1):17-20.
[19] 孙绪生.简化太极拳运动中股四头肌角的变化[J].中国康复医学杂志, 2003, 18(1):42-43.
[20] Yoo JH,Choi IH,Cho TJ,et al.Development of tibiofemoralanglein Korean children[J].J Korean Med Sci,2008,23(4):714-717.
[21] Kurtoglu S,Mazicioglu MM,Ozturk A,et al.Interpopliteal distance percentiles to diagnose bowleg in 0-84 month-old Turkish children[J].Eur J Pediatr, 2011, 170(9):1143-1150.
[22] Stevens PM,Klatt JB.Guided growth for pathological physes :radiographic improvement during realignment[J].J Pediatr Orthop,2008,28(6):632-639.