scholarly journals LEG LENGTH DISCREPANCY IN ADOLESCENT IDIOPATHIC SCOLIOSIS

2019 ◽  
Vol 18 (3) ◽  
pp. 192-195
Author(s):  
EDUARDO MOREIRA PINTO ◽  
JORGE ALVES ◽  
ALFREDO MENDES DE CASTRO ◽  
SILVA MARCOS ◽  
JOSÉ MIRADOURO ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Case Series ◽  
Leg Length Discrepancy ◽  
X Rays ◽  
Leg Length ◽  
Coronal Balance ◽  
Length Discrepancy ◽  
Lenke Classification ◽  
Left Limb

ABSTRACT Objective The objective of this study is to evaluate leg length discrepancy in adolescent idiopathic scoliosis. Methods A retrospective study of 80 subjects with adolescent idiopathic scoliosis (AIS) was conducted. The inclusion criteria were patients aged 10 to 18 years old with posteroanterior (PA) and lateral full-length radiographs. The exclusion criteria were patients subjected to surgery or orthotic treatment, those with other spinal disease, and those with poor quality x-rays. The parameters evaluated were: age, sex, Risser stage (RS), triradiate cartilage (TC), scoliotic curvatures, differentiated according to Lenke classification, sagittal (SB) and coronal balance (CB), and leg length discrepancy, which was assessed through the difference between the femoral heads (LLD) and through the assessment of pelvic obliquity (PO). Results The majority of patients with AIS demonstrated a mild LLD (<1 cm). The mean LLD was significantly different (p<0.01) between the scoliotic population with a main thoracolumbar curvature and those with a main lumbar curvature. When there was an LLD, it was the left limb that was shortened in most cases. The side of the longer lower limb had a direct influence on the CB (p=0.052). Conclusions This study demonstrates that in an AIS population with small LLD values, the extent of the shortening has a stronger impact on coronal balance and location than on the dimension of the main scoliotic curvature. These results demonstrate the importance of a more in-depth study on the effects of LLD <1 cm in the development of AIS and coronal imbalance. Level of evidence IV; Case Series.

Orthopaedic management of leg length discrepancy in Proteus syndrome: a case series

2017 ◽  
Author(s):  
Molly Crenshaw ◽  
Cara Goerlich ◽  
Lauren Ivey ◽  
Julie Sapp ◽  
Kim Keppler-Noreuil ◽  
...  
Keyword(s):  
Case Series ◽  
Leg Length Discrepancy ◽  
Proteus Syndrome ◽  
Leg Length ◽  
Length Discrepancy

scholarly journals Assisted Preoperative Planning in Total Hip Arthroplasty to Reduce Leg Length Discrepancy

10.29007/w6vh ◽  
2019 ◽  
Author(s):  
Paolo Esposito ◽  
Giovanni Francesco Solitro ◽  
Farid M.L. Amirouche ◽  
Damiano Fortuna ◽  
Arcangelo Pellegrino ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Leg Length Discrepancy ◽  
Second Phase ◽  
Angular Deviation ◽  
Anatomical Landmarks ◽  
X Rays ◽  
Leg Length ◽  
Length Discrepancy ◽  
Press Fit ◽  
Intramedullary Canal

Preoperative planning is an integral part of total joint arthroplasty, aiming to restore the joint mimicking the native functionality (Choplin 2008).Dimensions of bone and prosthetic implants are usually evaluated by preoperative radiographs to restore leg length discrepancy and femoral offset (Amirouche et al 2015).Nevertheless, even when using dedicated software, the femoral component is precisely selected only in 34% of the cases, resulting in a significant variability in 50% of the patients with 10mm in postoperative leg length discrepancy (Strøm e Reikerås 2018) With the aim of reducing postoperative complications, in this work a computer algorithm has been developed that uses preoperative x-rays and performs automatic extraction of anatomical landmarks together with an automatic selection of the component that closely restore the native hip. In a first phase, the Fuzzy logic based algorithm extracts the axis of the femoral neck, the femoral axis of the middle diaphysis,both the trochanters and the center of the femoral head.Then,by checking the geometrical data of commercially available hardware selects the component closer to the native anatomy. In a second phase,by a kinematic approximation the algorithm uses the segmentation of the intramedullary canal to position the implant,assuming a press-fit insertion and thus anticipating potential contact region and, consequently, leg length discrepancy and offset. The algorithm has been tested on a set of x-ray images. The correlation diagram is used to determine the femur length bt means of the diameter of the femoral head. A sample of 16 femoral radiographs in Antero-posterior view was used to validate the algorithm. The head size was used to evaluate the error between the dimension calculated and the one manually measured on the radiograph, resulting in the order of + 2.00 mm.The prediction of the fixation by means of press-fit technique gives an average contact height of 21.49 mm and an angular deviation of 4.13 ° of the neck axis, applying a force of 9.25 kN (Sakai 2011).Compared to existing methods, the proposed algorithm allows to calculate the femoral sizes necessary for dimensioning the implant from 2D radiographs in the frontal view only and to predict the prosthesis-bone contact in terms of height and interference reached after hammering.It has to be noted that the study, based on coronal x-rays, does not actually account for pelvic tilt (Bono 2018), that will be include in a further research.

scholarly journals Guided Growth in Leg Length Discrepancy in Beckwith-Wiedemann Syndrome: A Consecutive Case Series

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1152
Author(s):  
Maurizio De Pellegrin ◽  
Lorenzo Brogioni ◽  
Guy Laskow ◽  
Graziano Barera ◽  
Roberta Pajno ◽  
...  
Keyword(s):  
Genetic Disorder ◽  
Case Series ◽  
Invasive Procedure ◽  
Leg Length Discrepancy ◽  
Vascular Lesions ◽  
Abdominal Wall Defects ◽  
Leg Length ◽  
Guided Growth ◽  
Length Discrepancy

Beckwith-Wiedemann Syndrome (BWS) is a rare genetic disorder characterized by overgrowth, macroglossia, abdominal wall defects, neonatal hypoglycemia, predisposition to embryonal tumor, lateralized overgrowth, and leg length discrepancy (LLD), which can affect normal posture and gait. Aim of this study was to evaluate the effects of guided growth (temporary epiphysiodesis technique) as LLD management in BWS patients. Between 2007 and 2021, 22 BWS patients (15 F, 7 M) with a mean age of 7.9 years (2.9–14.4) and a mean LLD at first surgery of 3.65 cm (2–10), underwent temporary proximal tibial (PTE) and distal femur epiphysiodesis (DFE). In 18 patients the first surgical procedure was PTE, in one, DFE, and in 3 cases, PTE and DFE at the same time, respectively. Eleven patients reached equality of leg length after a mean follow-up of 7.7 years (3.7–13.0) and mean age of 13.3 years (12.7–27.5); 10 patients underwent 3 surgical procedures, one 7 procedures. Fifteen patients had no complications. No severe complications, infection, articular stiffness, or neuro-vascular lesions occurred in remaining patients; complications included secondary varus or valgus axial deviation in a total of 6 patients, and two screw breakages in two patients. Guided growth as a minimally invasive procedure seems efficient for LLD treatment with low complication rate in BWS patients.

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