Management of Leg Length Inequality

Description: Management of Leg Length Inequality from Journal of the Southern Orthopaedic Association James J. McCarthy, MD, and G. Dean MacEwen, MD Abstract Leg length inequality is common. Treatment objectives include obtaining leg length equality, producing a level pelvis, and improving function. Clinical assessment should include determination of a level pelvis with the patient standing using a set of blocks of various heights to estimate the amount of leg length inequality. Radiographic measures include the teleroentgenogram, orthoradiograph, and computed tomography (CT). A prediction of the ultimate leg length inequality at skeletal maturity will be needed to determine treatment. Our guidelines for treatment of leg length inequality are as follows: <2 cm -- no treatment or a lift in the shoe; 2 to 6 cm -- an epiphysiodesis or shortening procedure is considered; 6 to 15 cm -- a lengthening procedure is considered. A leg length inequality of 15 to 20 cm -- may require a staged lengthening, lengthening combined with epiphysiodesis, or amputation. Numerous complications of limb lengthening procedures occur frequently, even in experienced hands. Medscape