南京市1~5岁儿童下肢发育与步态问题的调查及分析

目的 分析1~5岁儿童下肢骨骼发育与步态问题之间的联系,为儿科临床医生诊断儿童步态问题、提出早期干预措施提供依据。方法 随机选取2012年1月-2016年12月在南京市妇幼儿童保健门诊体检的741名1~5岁儿童进行步态分析,同时进行股四头肌角(Q角)、下肢踝距、下肢旋转成角的测量。结果 1)不同年龄组儿童间的Q角和踝距数值均差异存在统计学意义(F=51.28、11.27,P均＜0.05)。2)1~5岁儿童随着年龄的增长Q角持续增大,至4岁时达到峰值,随后Q角值减小,且Q角这种随年龄的变化趋势无性别差异。3)当儿童存在生理性膝外翻、扁平足、双足旋前、足内旋这些下肢发育问题时,Q角和踝距的值都普遍偏大,且差异有统计学意义(P均＜0.05)。结论 1~5岁儿童股四头肌角、下肢踝距存在动态变化过程,并呈现随年龄增长先增大后减小的规律;当1~5岁儿童存在生理性膝外翻、扁平足、双足旋前、足内旋这些下肢发育问题时,Q角和踝距的值都普遍偏大。

Investigation and analysis of lower limb development and gait in children aged 1~5 in Nanjing

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.