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Femur length: The superior aspect of the femoral head and the distal portion of the medial femoral condyle. Tibial length: The medial tibial plateau and the tibial plafond; As previously mentioned, leg length difference can result from a repetitive activity that misaligns, one example being pelvic torsion; this is a functional LLD.
If left untreated, leg deformities, joint stiffness, leg-length discrepancy and pain will persist. [3] Diagnosis is done clinically and through X-ray imaging, with numerous classifications based on the severity of bowing and presence of fracture or intraosseous lesion. [4] Pathogenesis of CPT remains unclear.
Clinical feature: presents after the child has started walking but before six years of age. Usually associated with a painless hip due to mild abductor weakness and mild limb length discrepancy. If there is a bilateral involvement the child might have a waddling gait or trendelenburg gait with an increased lumbar lordosis.
limb length discrepancy (evaluated by placing the child in a supine position with the hips and knees flexed [unequal knee heights might be noticed – the Galeazzi sign]), and; restricted hip abduction. Sometimes during an exam a "click" or more precisely "clunk" in the hip may be detected [24] (although not all clicks indicate hip dysplasia). [25]
Klein's line or the line of Klein is a virtual line that can be drawn on an X-ray of an adolescent's hip parallel to the anatomically upper edge of the femoral neck.It was the first tool to aid in the early diagnosis of a slipped capital femoral epiphysis (SCFE), which if treated late or left untreated leads to crippling arthritis, leg length discrepancy and lost range of motion.
Common complications that can arise include leg-length discrepancy, joint contracture, growth retardation, low bone mineral density, and macrophage activation syndrome. [6] Some causes or potential risk factors denoting a higher chance of developing childhood arthritis have been identified. [7]
In a recent study, including newborns with high clinical suspicion for DDH (Ortolani/Barlow test, asymmetry in abduction of 20° or greater, breech presentation, leg-length discrepancy, and first-degree relative treated for DDH), hip sonography led to a change in clinical diagnosis in 52% of hips and to a change in management plan in 32% of hips.
Distraction osteogenesis (DO) is used in orthopedic surgery, and oral and maxillofacial surgery to repair skeletal deformities and in reconstructive surgery. [1] [2] [3] It was originally used to treat problems like unequal leg length, but since the 1980s is most commonly used to treat issues like hemifacial microsomia, micrognathism (chin so small it causes health problems), craniofrontonasal ...