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Management of leg length inequality.

Abstract
Leg length inequality is common. Treatment objectives include obtaining leg length equality, producing a level pelvis, and improving function. Clinical assessment should include determination of a level pelvis with the patient standing using a set of blocks of various heights to estimate the amount of leg length inequality. Radiographic measures include the teleroentgenogram, orthoradiograph, and computed tomography (CT). A prediction of the ultimate leg length inequality at skeletal maturity will be needed to determine treatment. Our guidelines for treatment of leg length inequality are as follows: <2 cm--no treatment or a lift in the shoe; 2 to 6 cm--an epiphysiodesis or shortening procedure is considered; 6 to 15 cm--a lengthening procedure is considered. A leg length inequality of 15 to 20 cm--may require a staged lengthening, lengthening combined with epiphysiodesis, or amputation. Numerous complications of limb lengthening procedures occur frequently, even in experienced hands.
AuthorsJ J McCarthy, G D MacEwen
JournalJournal of the Southern Orthopaedic Association (J South Orthop Assoc) Vol. 10 Issue 2 Pg. 73-85; discussion 85 ( 2001) ISSN: 1059-1052 [Print] United States
PMID12132831 (Publication Type: Journal Article)
Topics
  • Bone Lengthening
  • Femur (surgery)
  • Humans
  • Leg Length Inequality (diagnostic imaging, surgery, therapy)
  • Orthotic Devices
  • Osteogenesis, Distraction
  • Radiography

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