Leg length discrepancy is not a risk factor for plantar fasciitis.

PURPOSE: Plantar fasciitis (PF) is a main source of heel pain, and only about one-third of patients have bilateral symptomatic involvement, although age, body mass index (BMI), and physical activities are known risk factors. The high prevalence of unilateral involvement is poorly understood. We aimed to assess the potential association between PF and the leg length discrepancy (LLD) in unilateral PF. METHODS: A transversal case-control study was conducted from January 2019 to December 2020, including 120 participants allocated to two groups matched by BMI and sex: cases (with a diagnosis of PF; 50 ± 13 years) and control (without foot pain; 40 ± 15 years). For both groups, a difference greater than 0.64 cm in the scanometry determined the criteria for the presence of LLD. RESULTS: The multivariate logistic regression analysis showed an independent association of PF only with age (p < 0.001), and no association with LLD. We did not observe differences in the mean discrepancy (1.37 ± 0.83 cm in the PF group in comparison with 1.13 ± 0.37 cm in the control group, [p > 0.05]) or in the prevalence of LLD between groups (48% [n = 29] in the PF group compared with 42% [n = 25] in the control group, [p > 0.05]). In the PF group, 80% of the participants reported unilateral pain. We observed a higher prevalence of pain in the shorter limb (p < 0.05). CONCLUSION: Age was the only factor associated with the diagnosis of PF when groups were matched by sex and BMI. LLD was not an independent factor associated with the diagnosis of PF. However, when PF is unilateral, the shorter limb is more affected with 70% of prevalence. LEVEL OF EVIDENCE: Level III, case-control.

Magnitude of Change in Leg Length and Clinical Impact Following Medial Unicompartmental Knee Arthroplasty.

BACKGROUND: Change in leg length and leg-length discrepancy (LLD) are common concerns among patients undergoing medial unicompartmental knee arthroplasty (UKA). This study aimed to quantify the magnitude of leg-length change, prevalence of postoperative LLD, and their clinical implications following medial UKA. METHODS: Leg length and mechanical hip-knee-ankle angle (mHKA) were retrospectively measured in 332 patients following unilateral robotic-arm assisted medial UKA for medial compartment osteoarthritis, using calibrated long-leg radiographs. The Knee Injury and Osteoarthritis Otcome Score for Joint Replacement and patient satisfaction were analyzed to assess impact of leg-length change and LLD on outcomes. RESULTS: Following medial UKA, median leg-length change was 2.0 mm (interquartile range, -1.0 to 5.0 mm; P < .001) with a mean correction in mHKA of 4.4° ± 2.7 (P < .001). A total of 158 patients (48%) had a leg-length increase by 0 to 5 mm, 64 (19%) by 6 to 10 mm, and 11 (3%) by >10 mm. Leg-length change was positively correlated with mHKA correction (R = 0.44, P < .001). Postoperatively, moderate (5 to 10 mm) and substantial LLD (≥10 mm) were present in 49% and 17% of patients, respectively. Four-year Knee Injury and Osteoarthritis Outcome Score for Joint Replacement were comparable between patients with and without substantial postoperative LLD (P = .976). Proportions of satisfied patients were similar between groups (P = .687). CONCLUSION: Following medial UKA, the majority of patients had a moderate increase in leg length, the magnitude of which was positively correlated to the correction in mechanical alignment. Postoperative substantial LLD was not uncommon (17% prevalence); however, it had no significant impact on patient-reported outcomes or satisfaction at 4 years follow-up.

Estudio y valoración de los cambios introducidos en el nuevo baremo relativos a las secuelas traumatológicas en los cuatro miembros / Study and rating of changes in the new scale relating to the traumatic aftermath in four limbs

Las secuelas traumatológicas que afectan a cualquiera de los miembros constituyen uno de los apartados de más prevalencia e interés en la valoración del daño corporal. Suelen estar presentes en cualquier politraumatizado así como en cualquier tipo de agresión, tanto del agresor como del agredido. Estas secuelas tienen como origen cualquier daño o lesión, bien osteoarticular, bien de las partes blandas de los referidos miembros. Sea cual fuere la estructura dañada, el resultado va a ser un déficit o limitación en la movilidad de dicho segmento con la consiguiente pérdida funcional. Cuando usamos la palabra «déficit» nos estamos refiriendo a cualquier tipo de estado residual (amputación, limitación articular, rigidez, desviación, algias, etc.) que altere y menoscabe la funcionalidad de dicho miembro. El objeto del presente baremo no es otro que el de servir al perito médico para encuadrar y ponderar la secuela con la única finalidad de «tratar» de resarcir económicamente al lesionado. El baremo objeto del presente estudio ha mejorado el anterior en determinados aspectos. Ha reordenado y añadido distintas secuelas que en el anterior no existían y ha mejorado la puntuación de las mismas tanto en el valor promedio como en los límites de cada rango para evitar coincidencias con los adyacentes. No obstante, no existe uniformidad en las secuelas articulares, la ponderación de alguna de ellas no es la adecuada y existen lagunas en relación con determinados déficits y deformidades que no vienen recogidas en este nuevo baremo (AU)

The orthopaedic sequelae affecting any of the members of the sections are of more prevalence and interest in the valuation of bodily harm. They are usually present in any multisystem trauma patients as well in any kind of aggression in both the aggressor and the aggrieved. These aftereffects result from any damage or injury either osteo-articular soft tissue either of the aforementioned members. Whatever the damaged structure the result will be a deficit or limitation in mobility in this segment with the consequent loss of function. When we use the word ‘deficit’ we are referring to any type of residual state (amputation, joint limitation, stiffness, deviation, pains, etc.) altering and impairing the functionality of that member. The purpose of this scale is none other than to serve the coroner to frame and weigh any sequel with the sole purpose of ‘trying’ to financially compensate the injured. This scale object of this study has been able to improve the above in certain respects. It has been rearranged and has added different effects that did not exist in the previous one, and improved their score in both the average value and the limits of each range to avoid any overlaps. However, there is no uniformity in the joint sequels, the burden of some of them is not adequately assessed and there are gaps in relation to certain deficits and deformities that are not included in this new scale (AU)