Leg Length Inequality
Spinal Curvatures
Acute systematic and variable postural adaptations induced by an orthopaedic shoe lift in control subjects. (1/233)
A small leg length inequality, either true or functional, can be implicated in the pathogenesis of numerous spinal disorders. The correction of a leg length inequality with the goal of treating a spinal pathology is often achieved with the use of a shoe lift. Little research has focused on the impact of this correction on the three-dimensional (3D) postural organisation. The goal of this study is to quantify in control subjects the 3D postural changes to the pelvis, trunk, scapular belt and head, induced by a shoe lift. The postural geometry of 20 female subjects (X = 22, sigma = 1.2) was evaluated using a motion analysis system for three randomised conditions: control, and right and left shoe lift. Acute postural adaptations were noted for all subjects, principally manifested through the tilt of the pelvis, asymmetric version of the left and right iliac bones, and a lateral shift of the pelvis and scapular belt. The difference in the version of the right and left iliac bones was positively associated with the pelvic tilt. Postural adaptations were noted to vary between subjects for rotation and postero-anterior shift of the pelvis and scapular belt. No notable differences between conditions were noted in the estimation of kyphosis and lordosis. The observed systematic and variable postural adaptations noted in the presence of a shoe lift reflects the unique constraints of the musculoskeletal system. This suggests that the global impact of a shoe lift on a patient's posture should also be considered during treatment. This study provides a basis for comparison of future research involving pathological populations. (+info)Intraoperative limb length measurement in total hip arthroplasty. (2/233)
In order to evaluate the efficacy of intraoperative measurement of limb length inequality (LLI), we performed a prospective study on 64 patients who underwent unilateral total hip arthroplasty. The patients were divided into 2 groups. In Group I, the LLI was evaluated by the Shuck test, and in Group II by intraoperative measurement using a Steinman pin and an adjustable caliper. Preoperative LLIs assessed on radiographs averaged 1.18 cm in Group I and 0.37 cm in Group II. (+info)Spontaneous or traumatic premature closure of the tibial tubercle. (3/233)
A premature closure of the physis of the tibial tubercle in a young man has given rise to a shortening of the tibia, a patella alta and a reversed tibial slope of 20 degrees with clinical genu recurvatum. After a proximal open wedge tibial osteotomy all three postural deformities could be restored. The etiology of this complex deformity is discussed. (+info)Slipped capital femoral epiphysis after septic arthritis of the hip in an adolescent: report of a case. (4/233)
Septic arthritis of the hip must be managed promptly to avoid the serious complications associated with the condition. In the case reported here, the diagnosis was delayed and was complicated by a slipped capital femoral epiphysis. The patient, an adolescent boy previously in good health, presented with a 2-week history of hip pain and systemic illness. Septic arthritis was diagnosed and was managed by incision and drainage and antibiotic therapy. Two weeks later he presented with a subcutaneous abscess and a slipped capital femoral epiphysis, which was pinned in situ. There was a 2.5-cm leg-length discrepancy. Avascular necrosis of the femoral head subsequently developed leaving the boy with a permanent disability. (+info)Spontaneous healing of an atrophic pseudoarthrosis during femoral lengthening. A case report with six-year follow-up. (5/233)
A seven-year old girl developed an atrophic pseudoarthrosis at the midshaft of the femur with 8.5 cm of femoral shortening after an open type II fracture. During a femoral lengthening procedure, the pseudoarthrosis filled with spontaneous callus formation and bone union was obtained. (+info)Prevention of leg length discrepancy in young children with pauciarticular juvenile rheumatoid arthritis by treatment with intraarticular steroids. (6/233)
OBJECTIVE: To determine if intraarticular (i.a.) injection of triamcinolone hexacetonide (steroids) used early in the course of pauciarticular juvenile rheumatoid arthritis (pauci JRA) is associated with less leg length discrepancy (LLD) or thigh circumference discrepancy (TCD). METHODS: Children with pauci JRA who had asymmetric lower-extremity arthritis diagnosed before age 7 years in Seattle, Washington (WA; n = 16) and in Chapel Hill and Durham, North Carolina (NC; n = 14) were retrospectively identified. WA children were given i.a. steroids within 2 months of diagnosis; the injections were repeated if synovitis recurred in the same joint or in a different joint. These children were compared with NC children who were not treated with i.a. steroids. Thigh circumference was measured at 10 cm above the patella, and leg length was measured from the anterior superior iliac spine to the mid-medial malleolus, by a single observer. LLD and TCD are reported as the percentage of difference between leg measurements in each subject. RESULTS: The WA and NC subjects had comparable disease severity and duration of followup (in months). Twelve WA children had subsequent i.a. steroid injections (mean 3.25 injections per child over mean +/- SD 42 +/- 11 months). The WA subjects had significantly less LLD (P = 0.005, by Student's 2-sided t-test) and prescriptions for shoe lifts (P = 0.002, by Fisher's 2-sided exact test). There was not a significant difference in TCD between the 2 groups (P = 0.139, by Student's 2-sided t-test). Similar findings were obtained when the analysis was limited to children with monarticular knee arthritis. CONCLUSION: Early and continued use of i.a. steroids may be associated with less LLD in young children with pauci JRA. This may indicate decreased duration of synovitis. (+info)Leg lengthening over an intramedullary nail. (7/233)
Distraction osteogenesis is widely used for leg lengthening, but often requires a long period of external fixation which carries risks of pin-track sepsis, malalignment, stiffness of the joint and late fracture of the regenerate. We present the results of 20 cases in which, in an attempt to reduce the rate of complications, a combination of external fixation and intramedullary nailing was used. The mean gain in length was 4.7 cm (2 to 8.6). The mean time of external fixation was 20 days per centimetre gain in length. All distracted segments healed spontaneously without refracture or malalignment. There were three cases of deep infection, two of which occurred in patients who had had previous open fractures of the bone which was being lengthened. All resolved with appropriate treatment. This method allows early rehabilitation, with a rapid return of knee movement. There is a lower rate of complications than occurs when external fixation is used on its own. The time of external fixation is shorter than in other methods of leg lengthening. The high risk of infection calls for caution. (+info)Arrest of the growth plate after arterial cannulation in infancy. (8/233)
Seven children who had partial arrest of the growth plate after neonatal arterial cannulation, developed obvious skeletal changes in adolescence. Cannulation of the femoral artery produced ischaemia which led to four cases of ipsilateral shortening of the lower limb and one of partial arrest of the proximal femoral physis with subsequent coxa valga. The two arrests in the upper limb affected the humerus, ulna and radius, and the radius alone, after cannulation of the brachial and radial arteries, respectively. These late effects of cannulation are not widely appreciated, and may occur as a result of thrombosis rather than extravasation. (+info)'Leg length inequality' (LLIS) is a condition where there is a discrepancy in the lengths of an individual's lower extremities, specifically the bones of the thigh (femur) and/or the leg (tibia/fibula). This discrepancy can be congenital or acquired due to various causes such as fractures, infections, or surgical procedures. The inequality can lead to functional scoliosis, lower back pain, and other musculoskeletal issues. It is typically diagnosed through physical examination and imaging studies like X-rays, and may be treated with various methods including orthotics, shoe lifts, or in some cases, surgical intervention.
Spinal curvatures refer to the normal or abnormal curvature patterns of the spine as viewed from the side. The human spine has four distinct curves that form an "S" shape when viewed from the side: cervical, thoracic, lumbar, and sacral. These natural curves provide strength, flexibility, and balance to the spine, allowing us to stand upright, maintain proper posture, and absorb shock during movement.
Abnormal spinal curvatures are often referred to as spinal deformities and can be classified into two main categories: hyperkyphosis (increased kyphosis) and hyperlordosis (increased lordosis). Examples of such conditions include:
1. Kyphosis: An excessive curvature in the thoracic or sacral regions, leading to a hunchback or rounded appearance. Mild kyphosis is common and usually not problematic, but severe cases can cause pain, breathing difficulties, and neurological issues.
2. Lordosis: An abnormal increase in the curvature of the lumbar or cervical spine, resulting in an exaggerated swayback posture. This can lead to lower back pain, muscle strain, and difficulty maintaining proper balance.
3. Scoliosis: A lateral (side-to-side) spinal curvature that causes the spine to twist and rotate, forming a C or S shape when viewed from behind. Most scoliosis cases are idiopathic (of unknown cause), but they can also be congenital (present at birth) or secondary to other medical conditions.
These abnormal spinal curvatures may require medical intervention, such as physical therapy, bracing, or surgery, depending on the severity and progression of the condition.
Photogrammetry is not typically considered a medical term, but rather it is a technique used in various fields including engineering, architecture, and geology. However, it has found some applications in the medical field, particularly in orthopedics and wound care. Here's a definition that covers its general use as well as its medical applications:
Photogrammetry is the science of making measurements from photographs, especially for recovering the exact positions of surface points on an object. It involves the use of photography to accurately measure and map three-dimensional objects or environments. In the medical field, photogrammetry can be used to create 3D models of body parts (such as bones or wounds) by capturing multiple images from different angles and then processing them using specialized software. These 3D models can help healthcare professionals plan treatments, monitor progress, and assess outcomes in a more precise manner.
In medical terms, the leg refers to the lower portion of the human body that extends from the knee down to the foot. It includes the thigh (femur), lower leg (tibia and fibula), foot, and ankle. The leg is primarily responsible for supporting the body's weight and enabling movements such as standing, walking, running, and jumping.
The leg contains several important structures, including bones, muscles, tendons, ligaments, blood vessels, nerves, and joints. These structures work together to provide stability, support, and mobility to the lower extremity. Common medical conditions that can affect the leg include fractures, sprains, strains, infections, peripheral artery disease, and neurological disorders.