title: Limb length discrepancy in cutis marmorata telangiectatica congenita: an audit of assessment and management in a multidisciplinary setting.
abstract: BACKGROUND
  Cutis marmorata telangiectatica congenita (CMTC) is a vascular malformation, diagnosed based on cutaneous manifestations. It is associated with limb length discrepancy (LLD) and asymmetry, but the exact extent of this and its relationship to the site of the cutaneous manifestations have not been delineated.
  
  
  OBJECTIVE
  To review the orthopaedic problems associated with CMTC, concentrating on the assessment and management of the LLD.
  
  
  METHODS
  This study is a retrospective analysis of orthopaedic, dermatological and vascular data that were collected prospectively at our tertiary referral centre. We identified 80 patients with an initial diagnosis of CMTC; 57/69 patients with a confirmed diagnosis had lower-limb involvement.
  
  
  RESULTS
  An LLD was identified in 51% of cases. The discrepancy was significant (defined as ≥ 2 cm) in nine patients and was confirmed using standing leg-length radiographs. Of these patients, three had epiphysiodesis to correct the discrepancy, and surgery is planned in five others.
  
  
  CONCLUSIONS
  Limb length discrepancy and asymmetry are common in CMTC; however, this is below the significant threshold in most cases. It is therefore recommended that any discrepancy be initially monitored clinically. This should be followed by standing leg-length radiographs at the age of 10 years (girls) or 12 years (boys), or if the LLD is ≥ 2 cm. If this is confirmed radiologically, orthopaedic referral is advised to consider surgical intervention such as epiphysiodesis.
authors.affiliation: Department of Orthopaedics, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, U.K.
authors.forename: A
authors.initials: A
authors.lastname: Memarzadeh
authors.forename: I
authors.initials: I
authors.lastname: Pengas
authors.forename: S
authors.initials: S
authors.lastname: Syed
authors.forename: D M
authors.initials: DM
authors.lastname: Eastwood
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007870:Leg Length Inequality / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D054068:Livedo Reticularis; D008297:Male; D010348:Patient Care Team; D011446:Prospective Studies; D012189:Retrospective Studies; D017445:Skin Diseases, Vascular / Q000150:complications*; D013684:Telangiectasis / Q000150:complications / Q000151:congenital*