Leg Length Discrepancy

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Leg length discrepancy also known as leg length inequality refers to unequal lower limb lengths. It may a factor for pain in hip osteoarthritis, knee osteoarthritis, and chronic low back pain.

Aetiology

Anatomic: This refers to LLD due to fracture, trauma to the growth plate, degenerative disorders, post arthroplasty, or idiopathic developmental abnormalities

Function: This refers to joint contracture, soft tissue shortening, ligamentous laxity, axial malalignment, and abnormal foot mechanics.

Environmental: repeated exposure to uneven ground such as repeated running on a cambered road.

Developmental: May arise as part of physiologic growth.

Classification

Mild: <30mm
Moderate: 30-60mm
Severe: >60mm

Epidemiology

LLD is present in up to 90% of the population, with 59% having an LLD of at least 5mm.

Clinical Features

LLD may be a source of pain and disability.^[1]

Knee and hip osteoarthritis may develop in the longer limb.

Treatment

There is low quality evidence that shoe lifts reduce pain and improve function in patients with LLD and associated painful musculoskeletal conditions.^[2]

Surgery can be considered if the discrepancy is over 25mm.

Resources

Shoe lifts for leg length discrepancy systematic review - Campbell 2017 - 355 KB (f)

References

↑ Gurney, Burke (2002-04). "Leg length discrepancy". Gait & Posture. 15 (2): 195–206. doi:10.1016/s0966-6362(01)00148-5. ISSN 0966-6362. PMID 11869914. Check date values in: |date= (help)
↑ Campbell, T. Mark; Ghaedi, Bahareh Bahram; Tanjong Ghogomu, Elizabeth; Welch, Vivian (2018-05). "Shoe Lifts for Leg Length Discrepancy in Adults With Common Painful Musculoskeletal Conditions: A Systematic Review of the Literature". Archives of Physical Medicine and Rehabilitation. 99 (5): 981–993.e2. doi:10.1016/j.apmr.2017.10.027. ISSN 1532-821X. PMID 29229292. Check date values in: |date= (help)

Literature Review

Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf

Articles from all years: PubMed search, Google Scholar search.

TRIP Database: clinical publications about evidence-based medicine.

Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,

[1] Gurney, Burke (2002-04). "Leg length discrepancy". Gait & Posture. 15 (2): 195–206. doi:10.1016/s0966-6362(01)00148-5. ISSN 0966-6362. PMID 11869914. Check date values in: |date= (help)

[2] Campbell, T. Mark; Ghaedi, Bahareh Bahram; Tanjong Ghogomu, Elizabeth; Welch, Vivian (2018-05). "Shoe Lifts for Leg Length Discrepancy in Adults With Common Painful Musculoskeletal Conditions: A Systematic Review of the Literature". Archives of Physical Medicine and Rehabilitation. 99 (5): 981–993.e2. doi:10.1016/j.apmr.2017.10.027. ISSN 1532-821X. PMID 29229292. Check date values in: |date= (help)

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