Ipsilateral Healthy-segment Response to Leg Length Discrepancy.
J Pediatr Orthop
; 44(1): e57-e60, 2024 Jan 01.
Article
en En
| MEDLINE
| ID: mdl-37867312
ABSTRACT
BACKGROUND:
Few studies address frequency or magnitude of healthy lower-extremity segment response to ipsilateral companion segment shortening. We sought to document and quantify this occurrence in a variety of pediatric etiologies.METHODS:
We reviewed the medical record and radiographs of patients undergoing epiphysiodesis to manage leg length discrepancy. Inclusion criteria for this study were leg length discrepancy of a single lower-extremity segment by identifiable cause and adequate scanograms to allow accurate measurement of all 4 lower-extremity segments before any surgical treatment for the discrepancy. We recorded the etiology of shortening, age of onset of disorder, the length of the lower-extremity segments on scanograms, and age at the time of radiographs. We considered ipsilateral healthy-segment difference from the contralateral ≥ 0.5 cm. as clinically significant.RESULTS:
Two hundred nine patients met inclusion criteria (126 boys, 83 girls). The average age was 12.5 years. 16/60 patients with avascular necrosis of the hip demonstrated ipsilateral tibial shortening averaging 1.2 cm whereas 6/60 demonstrated ipsilateral tibial overgrowth averaging 0.6 cm. 11/30 Legg-Perthés patients demonstrated ipsilateral tibial shortening averaging 0.7 cm; none had ipsilateral tibial overgrowth. 10/42 posteromedial bow patients had ipsilateral femoral shortening averaging 0.8 cm, whereas 6/42 had ipsilateral overgrowth averaging 0.8 cm. 13/48 with distal femoral physeal injury demonstrated ipsilateral tibial shortening averaging 1.2 cm, whereas 6/48 demonstrated ipsilateral tibial overgrowth averaging 0.8 cm. 8/29 tibial physeal injuries (proximal or distal) demonstrated ipsilateral femoral shortening averaging 1.1 cm. whereas 7/29 demonstrated ipsilateral femoral overgrowth averaging 0.7 cm.CONCLUSIONS:
Although there are individual exceptions, the ipsilateral healthy segment does not grow appreciably more than the contralateral in patients with avascular necrosis of the hip, Legg-Perthés disease, or physeal trauma. The femur is not a significant component of shortening in patients with posteromedial bow. LEVEL OF EVIDENCE Level III, retrospective review.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Osteonecrosis
/
Pierna
Límite:
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Pediatr Orthop
/
Journal of policy analysis and management (Online)
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos