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True Leg Length Discrepancy
Aka: True Leg Length Discrepancy, Leg Length Discrepancy, Limb Length Discrepancy, Leg Length Inequality
- See Also
- Functional Leg Length Discrepancy
- Causes
- Idiopathic unilateral hyperplasia or hypoplasia
- Growth Plate injury
- Trauma
- Infection
- Asymmetric paralysis
- Poliomyelitis
- Cerebral Palsy
- Mass induced growth
- Tumor
- Juvenile Rheumatoid Arthritis
- Post-Fracture hypervascularity
- Exam: Fixed point to fixed point testing
- Position
- Patient lies supine with legs in neutral position
- Measurement (compare both sides)
- Anterior superior iliac spine to medial malleolus
- Interpretation
- Leg Length Discrepancy if difference between sides
- Exam: Evaluate tibia and femur lengths
- Position
- Patient lies supine
- Knees flexed at 90 degrees and feet flat on table
- Interpretation
- One knee higher than other: Tibia longer
- One knee projects further anteriorly: femur longer
- Management: True Limb Length Discrepancy >1.5 cm
- Shoe lift or prosthetic conversion
- Surgical intervention
- Epiphysiodesis of long leg
- Long leg shortening or short leg lengthening
- Complications
- Compensatory Scoliosis
- Low Back Pain
- Gait abnormalities with secondary injuries
- References
- Canale (1998) Campbell's Orthopaedics, Mosby, p. 986
- Hoppenfeld (1976) Spine and Extremities, p. 165