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Tibial Torsion in Children of the Jeju Area

Korean Journal of Pediatrics 2005;48(1):75-80.
Published online January 15, 2005.
Tibial Torsion in Children of the Jeju Area
Dong Ho Song1, Baik-Lin Eun2, Sang Hee Park2, Joon Young Lee3, Young Chang Tockgo2
1Song's Pediatric Clinic, Jeju, Kore
2Department of Pediatrics, College of Medicine, Korea University, Seoul, Kore
3Department of Pediatrics, College of Medicine, Korea University, Seoul, Kore
제주지역 소아의 경골 염전
송동호1, 은백린2, 박상희2, 이준영3, 독고영창2
1송소아과의원
2고려대학교 의과대학 소아과학교실
3고려대학교 의과대학 예방의학교실
Correspondence: 
Dong Ho Song, Email: dh7974@pednet.cokr
Abstract
Purpose
: Internal tibial torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Internal tibial torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The purpose of this study is to measure the tibial torsion in children of the Jeju area.
Methods
: Tibial torsion was measured in 1,042 lower extremities of 521 children from one to 12 years of age. The values of transmalleolar angles were analyzed for each age group divided by 6 months. Quadratic and linear regression models were used to fit patterns of changes in mean values of transmalleolar angles. The age at seven, which provides the highest coefficient of determination for quadratic regression analysis, was used as a cut-off point to fit different statistical models.
Results
: The mean transmalleolar angle was 0.10?.79 in all children, 0.90?.49 in males, and -0.80?.97 in females. The value was 4.25?.04 in 1 year of age, gradually decreased to the lowest level of -1.98 in four years and seven months of age, increased again with age until it reached 0.67?.10 at seven years of age, and stayed at that level thereafter.
Conclusion
: Internal tibial torsion in infancy is known to correct spontaneously in the normal developing process. But in this study, the mean transmalleolar angle in children of Jeju area annually decreased after one year of age; to the lowest angle at four years and seven months of age; increased again gradually to the age of seven; and persisted in that level, about 10 less than western children, not correcting further thereafter. These findings suggest tibial torsion might be caused by lifestyle, especially sitting on feet. To prevent abnormalities of joints and gaits, early diagnosis of tibial torsion in childhood and posture correction or early treatment when needed, seems to be necessary.
Key Words: Tibia, Torsion, Korea, Child


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