II. Causes

  1. Idiopathic unilateral hyperplasia or hypoplasia
  2. Growth plate injury
    1. Trauma
    2. Infection
  3. Asymmetric paralysis
    1. Poliomyelitis
    2. Cerebral Palsy
  4. Mass induced growth
    1. Tumor
    2. Juvenile Rheumatoid Arthritis
    3. Post-Fracture hypervascularity

III. Exam: Fixed point to fixed point testing

  1. Position
    1. Patient lies supine with legs in neutral position
  2. Measurement (compare both sides)
    1. Anterior superior iliac spine to medial malleolus
  3. Interpretation
    1. Leg Length Discrepancy if difference between sides

IV. Exam: Evaluate tibia and femur lengths

  1. Position
    1. Patient lies supine
    2. Knees flexed at 90 degrees and feet flat on table
  2. Interpretation
    1. One knee higher than other: Tibia longer
    2. One knee projects further anteriorly: femur longer

V. Management: True Limb Length Discrepancy >1.5 cm

  1. Shoe lift or prosthetic conversion
  2. Surgical intervention
    1. Epiphysiodesis of long leg
    2. Long leg shortening or short leg lengthening

VI. Complications

  1. Compensatory Scoliosis
  2. Low Back Pain
  3. Gait abnormalities with secondary injuries

VII. References

  1. Canale (1998) Campbell's Orthopaedics, Mosby, p. 986
  2. Hoppenfeld (1976) Spine and Extremities, p. 165

Images: Related links to external sites (from Google)

Ontology: Leg Length Inequality (C0023221)

Definition (MSH) A condition in which one of a pair of legs fails to grow as long as the other, which could result from injury or surgery.
Definition (AOT) see:http://www.nlm.nih.gov/mesh/MBrowser.html
Concepts Anatomical Abnormality (T190)
MSH D007870
SnomedCT 45939007
English Inequalities, Leg Length, Leg Length Inequalities, Leg Length Inequality, Length Inequalities, Leg, Length Inequality, Leg, Inequality, Leg Length, Leg length discrepancy, Leg Length Inequality [Disease/Finding], leg length discrepancy, discrepancy leg length, inequality leg length, leg length inequalities, leg length inequality, Leg length inequality, Lower limb length difference, Leg length inequality (finding)
Swedish Benlängdsskillnad
Czech končetiny dolní nestejné délky
Finnish Alaraajojen pituusero
Russian KONECHNOSTEI NIZHNIKH NERAVNAIA DLINA, NOG NERAVNAIA DLINA, КОНЕЧНОСТЕЙ НИЖНИХ НЕРАВНАЯ ДЛИНА, НОГ НЕРАВНАЯ ДЛИНА
Croatian NOGA, NEJEDNAKA DULJINA
Polish Nierówność kończyn dolnych
Spanish desigualdad en la longitud de las piernas (hallazgo), desigualdad en la longitud de las piernas, disparidad en la longitud de las piernas, Desigualdad de Miembros Inferiores, Diferencia de Longitud de las Piernas
German Beinlängendifferenz, Beinlängenunterschied
Italian Asimmmetria degli arti inferiori
Dutch Beenlengte, ongelijke, Ongelijke beenlengte
Portuguese Desigualdade de Membros Inferiores
French Inégalité de longueur d'un membre inférieur, Inégalité de longueur des membres inférieurs

Ontology: True shortening of leg (C0426903)

Concepts Finding (T033)
SnomedCT 249788008
English Structural shortening of leg, True shortening of leg, True shortening of leg (finding)
Spanish acortamiento real de pierna (hallazgo), acortamiento real de pierna