Tumblelog by Soup.io
Newer posts are loading.
You are at the newest post.
Click here to check if anything new just came in.
lylasanlucas

True Leg Length Discrepancy Measurement

http://lylasanlucas.soup.io Overview

Small or mild length leg discrepancies (LLD), i.e., below 3.0 cm, have been considered as enough to cause orthopaedic changes such as lumbar pain, stress fractures and osteoarthritis on lower limbs (LLLL) joints. In addition to the classification by its magnitude, discrepancies can also be categorized according to etiology, being structural when a difference is noted between bone structures' length or functional as a result of mechanical changes on the lower limb, and are found in 65% - 70% of the healthy population.Leg Length Discrepancy

Causes

Limb-length conditions can result from congenital disorders of the bones, muscles or joints, disuse or overuse of the bones, muscles or joints caused by illness or disease, diseases, such as bone cancer, Issues of the spine, shoulder or hip, traumatic injuries, such as severe fractures that damage growth plates.

Symptoms

Many people walk around with LLD?s of up to 2 cm. and not even know it. However, discrepancies above 2 cm. becomes more noticeable, and a slight limp is present. But even up to 3 cm. a small lift compensates very well, and many patients are quite happy with this arrangement. Beyond 3 cm. however, the limp is quite pronounced, and medical care is often sought at that point. Walking with a short leg gait is not only unsightly, but increases energy expenditure during ambulation. It could also put more stress on the long leg, and causes functional scoliosis. Where the discrepancy is more severe, walking becomes grotesque or virtually impossible.

Diagnosis

On standing examination one iliac crest may be higher/lower than the other. However a physiotherapist, osteopath or chiropractor will examine the LLD in prone or supine position and measure it, confirming the diagnosis of structural (or functional) LLD. The LLD should be measured using bony fixed points. X-Ray should be taken in a standing position. The osteopath, physiotherapist or chiropractor will look at femoral head & acetabulum, knee joints, ankle joints.

Non Surgical Treatment

You and your physician should discuss whether treatment is necessary. For minor LLDs in adults with no deformity, treatment may not be necessary. Because the risks may outweigh the benefits, surgical treatment to equalize leg lengths is usually not recommended if the difference is less than one inch. For these small differences, your physician may recommend a shoe lift. A lift fitted to the shoe can often improve your walking and running, as well as relieve back pain caused by LLD. Shoe lifts are inexpensive and can be removed if they are not effective. They do, however, add weight and stiffness to the shoe.

LLD Shoe Inserts

leg length discrepancy hip pain

Surgical Treatment

Differences of an inch-and-a-half to two inches may require epiphysiodesis (adjusting the growth of the longer side) or acute shortening of the other side. Differences greater than 2.5 inches usually require a lengthening procedure. The short bone is cut and an external device is applied. Gradual lengthening is done over months to allow the muscles and nerves accommodate the new length.

Don't be the product, buy the product!

Schweinderl