All issues > Volume 48(1); 2005

Original Article

Korean J Pediatr. 2005;48(1):75-80. Published online January 15, 2005.

Tibial Torsion in Children of the Jeju Area

Dong Ho DH Song¹, Baik-Lin BL Eun², Sang Hee SH Park², Joon Young JY Lee³, Young Chang YC 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

Correspondence Dong Ho DH 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.

Keywords :Tibia, Torsion, Korea, Child