Management of Mild Lower Extremity Deformity and Leg Length Discrepancy

Abstract

Limb malalignment and length discrepancy are common problems treated by pediatric orthopaedic surgeons. These deformities may increase the rate of degenerative disease of the knee, hip, and spine. Previous teaching suggested that there were no long term consequences of mild deformity, however, newer studies suggest that there may be morbidity associated with as little at 5 mm of leg length discrepancy. There are many etiologies that can contribute to limb deformity, and so a thorough history and physical is key to management. Pediatric patients present the unique opportunity to utilize the growth of the physis to correct these deformities with adequate planning. Alternatively, lengthening techniques have become safer and are associated with excellent patient satisfaction. The mounting evidence of the long term consequences of leg deformity, coupled with more sophisticated correction techniques, brings traditional indications for deformity correction into question.