02
Ju
Leg Length Discrepancy After Knee Replacement Surgery
02.07.2017 09:39
Overview

There are generally two kinds of leg length discrepancies. Structural discrepancy occurs when either the thigh (femur) or shin (tibia) bone in one leg is actually shorter than the corresponding bone in the other leg. Functional discrepancy occurs when the leg lengths are equal, but symmetry is altered somewhere above the leg, which in turn disrupts the symmetry of the legs. For example, developmental dislocation of the hip (DDH) can cause a functional discrepancy. In DDH, the top of the leg bone (femur) that is not properly positioned in the hip socket may hang lower than the femur on the other side, giving the appearance and symptoms of a leg length discrepancy.Leg Length Discrepancy

Causes

There are many causes of leg length discrepancy. Some include, A broken leg bone may lead to a leg length discrepancy if it heals in a shortened position. This is more likely if the bone was broken in many pieces. It also is more likely if skin and muscle tissue around the bone were severely injured and exposed, as in an open fracture. Broken bones in children sometimes grow faster for several years after healing, causing the injured bone to become longer. A break in a child's bone through the growth center near the end of the bone may cause slower growth, resulting in a shorter leg. Bone infections that occur in children while they are growing may cause a significant leg length discrepancy. This is especially true if the infection happens in infancy. Inflammation of joints during growth may cause unequal leg length. One example is juvenile arthritis. Bone diseases may cause leg length discrepancy, as well. Examples are, Neurofibromatosis, Multiple hereditary exostoses, Ollier disease. Other causes include inflammation (arthritis) and neurologic conditions. Sometimes the cause of leg length discrepancy is unknown, particularly in cases involving underdevelopment of the inner or outer side of the leg, or partial overgrowth of one side of the body. These conditions are usually present at birth, but the leg length difference may be too small to be detected. As the child grows, the leg length discrepancy increases and becomes more noticeable. In underdevelopment, one of the two bones between the knee and the ankle is abnormally short. There also may be related foot or knee problems. Hemihypertrophy (one side too big) or hemiatrophy (one side too small) are rare leg length discrepancy conditions. In these conditions, the arm and leg on one side of the body are either longer or shorter than the arm and leg on the other side of the body. There may also be a difference between the two sides of the face. Sometimes no cause can be found. This is known as an "idiopathic" difference.

Symptoms

The effects of a short leg depend upon the individual and the extent of discrepancy. The most common manifestation if a lateral deviation of the lumbar spine toward the short side with compensatory curves up the spine that can extend into the neck and even impacts the TMJ. Studies have shown that anterior and posterior curve abnormalities also can result.

Diagnosis

A qualified musculoskeletal expert will first take a medical history and conduct a physical exam. Other tests may include X-rays, MRI, or CT scan to diagnose the root cause.

Non Surgical Treatment

In some circumstances, the physician will recommend a non-surgical form of treatment. Non-surgical treatments include orthotics and prosthetics. Orthotics are a special type of lift placed in or on a shoe that can be used in the treatment of leg length discrepancies between two and six centimeters. In pediatric patients who have large discrepancies and are not good candidates for other treatment forms, prosthetics can be helpful.

Leg Length Discrepancy

increase height quickly

Surgical Treatment

Your child will be given general anesthetic. We cut the bone and insert metal pins above and below the cut. A metal frame is attached to the pins to support the leg. Over weeks and months, the metal device is adjusted to gradually pull the bone apart to create space between the ends of the bones. New bone forms to fill in the space, extending the length of the bone. Once the lengthening process is completed and the bones have healed, your child will require one more short operation to remove the lengthening device. We will see your child regularly to monitor the leg and adjust the metal lengthening device. We may also refer your child to a physical therapist to ensure that he or she stays mobile and has full range of motion in the leg. Typically, it takes a month of healing for every centimeter that the leg is lengthened.

Comments


Datenschutzerklärung
Make your free website at Beep.com
 
The responsible person for the content of this web site is solely
the webmaster of this website, approachable via this form!