top of page

Topic:

Limb Length Discrepancy

Issue:

Leg

Category:

​

Title:

Ipsilateral Healthy-segment Response to Leg Length Discrepancy

Author:

Birch, John G. MD; Makarov, Marina R. MD; Jo, Chan-Hee PhD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e57-e60, DOI: 10.1097/BPO.0000000000002554

Level Of Evidence:

III

# of Patients:

209

Study Type:

Retrospective review

Location:

Not specified

Summary:

The study documents and quantifies healthy lower-extremity segment responses to ipsilateral segment shortening in a variety of pediatric etiologies.

Methods:

Inclusion Criteria: Patients with leg length discrepancy due to a single identifiable cause and adequate pre-treatment scanograms for measuring all four lower-extremity segments. Data Collection: The etiology of shortening, age of onset, leg segment lengths on scanograms, and age at radiographs were recorded. An ipsilateral healthy-segment difference ≥ 0.5 cm from the contralateral side was considered clinically significant.

Exclusions:

Not specified

Results:

Avascular Necrosis of the Hip: 16/60 patients showed ipsilateral tibial shortening (avg. 1.2 cm), 6/60 had overgrowth (avg. 0.6 cm). Legg-Perthés Disease: 11/30 had tibial shortening (avg. 0.7 cm), none showed overgrowth. Posteromedial Bow: 10/42 patients had femoral shortening (avg. 0.8 cm), 6/42 had overgrowth (avg. 0.8 cm). Distal Femoral Physeal Injury: 13/48 showed tibial shortening (avg. 1.2 cm), 6/48 showed overgrowth (avg. 0.8 cm). Tibial Physeal Injuries: 8/29 showed femoral shortening (avg. 1.1 cm), 7/29 showed overgrowth (avg. 0.7 cm).

Conclusions:

In cases of avascular necrosis of the hip, Legg-Perthés disease, or physeal trauma, the ipsilateral healthy segment does not typically exhibit significant overgrowth compared to the contralateral limb. The femur does not significantly contribute to shortening in patients with posteromedial bow.

Relevance:

Limitations:

Perspective:

bottom of page