Limb-length inequality: assessment and treatment options.
Assessment and treatment of limb-length inequality, particularly in the growing child, is a challenging task. Evaluation of the discrepancy requires an understanding of the significance of the disparity, as well as the natural history of the disorder, before formulation of a treatment plan. In the immature patient, consistent longitudinal data are essential to avoid pitfalls in the projection of ultimate length difference. Therapeutic options range from no treatment or use of a simple shoe lift to a surgical shortening or lengthening procedure. The current indication for lengthening is a disparity exceeding 5 to 6 cm. Epiphysiodesis or femoral shortening is useful for smaller discrepancies or for residual differences following a contralateral lengthening. Lengthening is done with a circular or cantilever external fixator, which may be combined with an intramedullary rod.
Stanitski
D F
DF
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston 29425, USA.
D000365:Age Determination by Skeleton; D001852:Bone Lengthening / Q000295:instrumentation / Q000379:methods; D002648:Child; D004838:Epiphyses / Q000601:surgery; D016267:External Fixators; D005269:Femur / Q000601:surgery; D005544:Forecasting; D006801:Humans; D007866:Leg / Q000254:growth & development; D007870:Leg Length Inequality / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D009989:Orthotic Devices; D010347:Patient Care Planning; D012775:Shoes