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True Leg Length Discrepancy
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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
Knee
s 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
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