Ethyl Sabine

I own me, and therefore, I can engineer me. I am me, and I am okay.

Overview


The majority of people in the world actually have some degree of leg length discrepancy, up to 2cm. One study found that only around 1/4 of people have legs of equal lengths. LLD of greater than 2cm is relatively rare, however, and the greater the discrepancy, the greater the chances of having a clinical problem down the road. A limp generally begins when LLD exceeds 2cm and becomes extremely noticeable above 3cm. When patients with LLD develop an abnormal gait, one of the debilitating clinical features can be fatigue because of the relatively high amount of energy needed to walk in the new, inefficient way. Poliomyelitis, or polio, as it is more commonly known, used to account for around 1/3 of all cases of LLD, but due to the effectiveness of polio vaccines, it now represents a negligible cause of the condition. Functional LLD, described above, usually involves treatment focused on the hip, pelvis, and/or lower back, rather than the leg. If you have been diagnosed with functional LLD or pelvic obliquity, please ask your orthopaedic surgeon for more information about treatment of these conditions.Leg Length Discrepancy


Causes


Leg length discrepancies can be caused by: hip and knee replacements, lower limb injuries, bone diseases, neuromuscular issues and congenital problems. Although discrepancies of 2 cm or less are most common, discrepancies can be greater than 6 cm. People who have LLD tend to make up for the difference by over bending their longer leg or standing on the toes of their shorter leg. This compensation leads to an inefficient, up and down gait, which is quite tiring and over time can result in posture problems as well as pain in the back, hips, knees and ankles.


Symptoms


Back pain along with pain in the foot, knee, leg and hip on one side of the body are the main complaints. There may also be limping or head bop down on the short side or uneven arm swinging. The knee bend, hip or shoulder may be down on one side, and there may be uneven wear to the soles of shoes (usually more on the longer side).


Diagnosis


The doctor carefully examines the child. He or she checks to be sure the legs are actually different lengths. This is because problems with the hip (such as a loose joint) or back (scoliosis) can make the child appear to have one shorter leg, even though the legs are the same length. An X-ray of the child?s legs is taken. During the X-ray, a long ruler is put in the image so an accurate measurement of each leg bone can be taken. If an underlying cause of the discrepancy is suspected, tests are done to rule it out.


Non Surgical Treatment


Treatment for an LLD depends on the amount of difference and the cause, if known. The doctor will discuss treatment options carefully with you and your child before any decisions are made. It is important to note that treatment is planned with the child?s final height and leg lengths in mind, not the current leg lengths. Treatment is generally not needed if the child?s final LLD is predicted to be 2 centimeters or less at full height. However, the child should return to an orthopaedic doctor by age 10 for re-evaluation. Treatment is often recommended for LLDs predicted to be more than 2 centimeters at full height. If treatment is done, it usually doesn?t begin until the child starts walking. Possible treatment options include, A ?lift? in one shoe to level the child?s hips. This is often the only treatment needed for small discrepancies.


Leg Length Discrepancy Insoles


Surgical Treatment


Large leg length inequalities can be treated by staged lengthenings or by simultaneous ipsilateral femoral and tibial lengthenings. Additionally, lengthenings can be combined with appropriately timed epiphysiodesis in an effort to produce leg length equality. Staged lengthenings are often used for congenital deficiencies such as fibular hemimelia, in which 15 cm or more may be needed to produce leg length equality. We typically plan for the final lengthening to be completed by age 13 or 14 years, and allow at least 3 years between lengthenings. Lengthening of both the tibia and femur simultaneously requires aggressive therapy and treatment of soft tissue contractures. Curran et al[57] reported the need for surgical release of soft tissue contractures in 3 of 8 patients treated with simultaneous ipsilateral femoral and tibial lengthenings. Lengthening over an IM nail can be done in an effort to decrease the amount of time the fixator needs to be worn and to prevent angular malalignment. This technique requires that the patient be skeletally mature and it carries a higher risk of osteomyelitis (up to 15%). Additionally, if premature consolidation occurs, a repeat corticotomy is more difficult.
Comments
Comment is pending approval.
Comment is pending blog author's approval.
2017/05/07(日) 14:50:54 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2017/05/07(日) 16:00:13 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2017/05/07(日) 16:26:30 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2017/05/07(日) 16:50:09 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2017/05/07(日) 18:51:37 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2017/05/07(日) 22:08:45 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2017/09/30(土) 03:10:12 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/01/18(木) 14:40:54 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/01/18(木) 18:40:58 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/01/19(金) 06:18:20 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/01/19(金) 23:54:23 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/01/24(水) 02:48:15 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/01/26(金) 16:18:02 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/01(木) 09:09:08 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/08(木) 02:03:28 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/08(木) 02:38:24 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/08(木) 04:40:19 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/08(木) 04:51:44 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/14(水) 00:12:11 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/17(土) 10:40:19 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/19(月) 00:09:06 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/19(月) 19:44:53 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/02/27(火) 18:31:05 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/03/08(木) 20:37:52 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/04/17(火) 18:01:51 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/05/29(火) 22:19:22 | | #[ Edit ]
Comment is pending approval.
Comment is pending blog author's approval.
2018/06/12(火) 21:53:04 | | #[ Edit ]
Post a comment
URL:
Body:
Edit password:
Private comment: Only the blog author may view the comment.
 
Trackbacks URL
http://ethylsabine.blog.fc2.com/tb.php/2-dab026c2
Use trackback on this entry.
Trackbacks