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Results for “Leg Length Inequality”
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[Significance of the correction of leg-length inequality in children].
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[Treatment of leg length inequality].
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[Practical method of prediction of leg length inequality].
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[Evaluation of operations correcting leg length inequality (author's transl)].
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[Value of neuropsychological examinations of patients with leg length inequality].
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[Treatment of leg length inequality, a result of poliomyelitis, by bone lengthening].
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[Operations to correct leg length inequality in the hip region (author's transl)].
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Proximal femoral focal deficiency.
Children with congenital focal deficiency of the proximal femur present many problems that are but rarely encountered by the individual surgeon who is thus unable to accumulate a wide experience. This paper reviews the literature and analyses the treatment of twenty-three cases at the Royal Children's Hospital, Melbourne, with the object of producing a rational plan of treatment. The management of instability of the hip, malrotation, inadequate proximal musculature and leg length inequality are separately considered for five grades of deficiency. Milder forms are amenable to subtrochanteric osteotomy to correct varus deformity. Exploration and grafting of the pseudarthrosis is indicated where progressive deformity develops. In the more severe deficiency, conservative management of the proximal bony defect provides a better result with an operation only rarely indicated. The gross leg length inequality may be most successfully overcome by Syme's amputation with subsequent fusion of the knee to create an above-knee amputee with an end-bearing stump allowing ready fitting of a prosthesis.
Staged femoral lengthening.
Lengthening of short femurs, including those with actual or anticipated shortening of several inches, has been carried out using serial lengthenings. Up to 5 individual lengthenings, each of approximately one inch, have been performed on involved femurs. In cases where shortening was due to epiphyseal injury, e.g. osteomyelitis of the distal femur, good results have been achieved. Congenital shortening has not been completely corrected because of subluxation of the hip during lengthening. The principle complication has been fracture through the plate and graft. Usually this fracture could be used as the indication for additional lengthening, thus minimizing the problem. It is believed that this approach offers advantages in terms of decreased total cost in time and money, making it suitable for private patients. An additional advantage is the lack of disastrous complications. Technical problems have been numerous, however. The procedure should not be undertaken casually or for minor leg length inequality.
Proximal femoral focal deficiency: a clinical appraisal.
In patients with unilateral proximal femoral focal deficiency, the leg length inequality is almost always greater than five inches at skeletal maturity. Consequently, prosthetic management should be planned before the patient walks. A standard plan of treatment of the patient with unilateral PFFD is not possible at this time, primarily because of the varying percentage of femur missing and the controversy of management of the hip in patients with type A or B deformity. However, we found that ankle disarticulation with Syme flap closure combined with arthrodesis of the knee is a reasonable plan in many patients with unilateral PFFD. This allows correction of the knee and hip flexion contractures and gives the patient a functional, cosmetic stump. By the time he begins school, he is functioning as an above-knee amputee. This is not an undesirable goal, as one of us (E.G.R.) recently examined an above-knee amputee, a Captain in the United States Army, who continued his hobby of sky diving.
Conversion of fused hips to low friction arthroplasty.
Fifty-four hips converted to low friction arthroplasty between 1965 and 1975 have been reviewed one to eleven years after operation. In many cases malposition had led to degenerative changes in the opposite hip, the lumbar spine or the knee, often with severe loss of function due to pain. It was found that total replacement could give useful relief of pain and improved function, though the range of movement obtained was not as good as in primary replacement. An outstanding feature was the correction of inequality of leg length. In general, the results were much better in cases of ankylosis acquired in adult life than in cases of spontaneous fusion after sepsis in childhood. The most important complication was a single case of sciatic palsy.
The ball and socket ankle joint.
This paper reports fifteen cases of ball and socket articulation at the ankle followed up for an average of twelve years. All patients showed inequality of leg length. Ten patients showed coalitions of the bones of the hindfoot and nine patients had a reduction in the number of bony elements of the forefoot. Other associated anomalies are described. The abnormality seems to be part of a congenital short-limb malformation, perhaps modified by adaptive change associated with rigidity of the hindfoot. Surgical intervention was not required in any patient in the series.
Abduction injuries of the distal femoral epiphysis.
Based on a follow-up study of 15 distal femoral epiphyseal fractures, the following conclusions are drawn: Closed reduction with cross pinning of the distal femoral epiphysis provided slightly better results and prevented loss of reduction; angulation deformity, requiring corrective surgery occurred in four patients, two of whom had initial anatomical reductions; significant leg length inequality was not seen; abduction injuries of the distal femoral epiphysis are not uncommon in teenage football players.
Robotic assistance in total hip arthroplasty: a systematic review and meta-analysis of leg length, cup orientation, and early outcomes.
This review examined whether robotic assistance alters postoperative leg-length discrepancy (LLD), acetabular cup orientation, or early hip-specific outcomes relative to conventional total hip arthroplasty (THA). We searched PubMed and Web of Science through May 2026 for comparative English-language reports. Study eligibility, data extraction, and methodological appraisal were undertaken independently by two reviewers. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated in Review Manager 5.4. Model selection was based on the target estimand and anticipated clinical and methodological diversity; leave-one-out and alternative-model sensitivity analyses were undertaken for heterogeneous outcomes. The protocol is registered with PROSPERO (CRD420261454043). The review included seven studies and 968 participants. Compared with conventional THA, robot-assisted THA yielded a smaller postoperative LLD (MD = -2.02, 95% CI -3.46 to -0.58; P = 0.006) and a higher Harris Hip Score (MD = 2.96, 95% CI 1.12 to 4.80; P = 0.002). Mean cup anteversion was lower in the robotic group (MD = -1.52, 95% CI -2.29 to -0.76; P < 0.0001), whereas cup inclination did not differ (MD = -0.71, 95% CI -3.26 to 1.83; P = 0.58). The robotic group also had higher Forgotten Joint Score (MD = 14.68, 95% CI 5.02 to 24.33; P = 0.003) and Oxford Hip Score values (MD = 2.61, 95% CI 0.71 to 4.51; P = 0.007). Robotic assistance was linked to a modest improvement in leg-length restoration and to higher scores on several early functional measures. The limited number of studies, predominance of nonrandomized designs, and marked heterogeneity in some analyses temper the certainty of these findings.
An advance in the treatment of leg inequality.
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Stimulation of bone growth by periosteal stripping. A clinical study.
Periosteal stripping in the long lower limb bones of thirty children with shortening after poliomyelitis was performed. All have been followed up for five years. A relative increase in length attributable to the periosteal stripping procedure was seen in the majority. The conclusions are that this simple procedure is indicated in minor degrees of limb inequality in growing children, but that the haphazare response precludes any accurate estimation of the final outcome of such a procedure.
Transiliac lengthening of the lower extremity. A modified innominate osteotomy for the treatment of postural imbalance.
A modified innominate osteotomy was employed to treat postural imbalance by a hemipelvic lengthening in twenty patients, five to twenty years old. Diagnoses associated with the postural imbalance included acetabular dysplasia with ipsilateral femoral shortening, pure limb-length inequality, primary intrapelvic asymmetry, and decompensated scoliosis. The functionally low hemipelvis was lengthened as much as three centimeters by distraction at the osteotomy and insertion of a quadrangular bone graft. The option of a variable amount of acetabular redirection was especially useful in patients with ipsilateral acetabular dysplasia. Review of the patients after two to six years revealed that an average lengthening of 2.3 centimeters had been achieved. Fourteen patients had a balanced stance without a lift postoperatively, and the size of the lift required in the other six patients was greatly reduced.