Limping gait improvement by femoral lengthening in ankylotic hips and limb length discrepancy in young adults.

Abstract

To investigate the clinical improvement of limping gait in patients with ankylotic hips and limb length discrepancy. From 1996 to 2005, 12 patients with ankylotic hips and limb length discrepancy were treated by distraction osteogenesis with a mono-lateral external fixator and an intramedullary nail. The limb length discrepancy was 6.20-12.50 (median 8.45) cm. Limping gait was classified according to the recommendations of the American Academy of Orthopedic Surgeons/Hip Society and scored according to Harris: no limping scored 11 points, mild limping scored 8 points, moderate limping scored 5 points, while severe limping scored 0 points. Limping gait was severe in all patients pre-operatively and the total score was 0. All patients were followed up for 30.00-46.00 (median 38.55) months, and all reported improvement in limping gait. The gain in length was 6.00-12.50 (median 8.20) cm, and the mean residual limb length discrepancy was 0-0.50 (median 0.20) cm. The total treatment time was 41.00-82.00 (median 61.50) weeks , the lengthening time was 14.00-38.00 (median 29.55) weeks. At the last follow-up, 10 patients had mild limping gait and 2 had moderate limping gait; the total score was 90.00. The median score was 7.50 (P(25) was 8.00, P(75) was 8.00). According to Wilcoxon signed rank test, the post-operative limping gait scores were significantly higher than pre-operative (P= 0.001). Femoral lengthening can improve the limping gait significantly in ankylotic hips and limb length discrepancy.