Results after Surgical Correction of Posttraumatic Leg Length Discrepancies

Abstract

The permanent correction of leg length discrepancies is essential for the prevention of painful osseous and soft-tissue sequelae. This correction may be effected conservatively with an orthopedic shoe or suitable orthosis, or operatively by means of a shortening or lengthening osteotomy [1,3,4]. An extremity that is elongated as a result of trauma should be surgically shortened if at all possible. In cases of posttraumatic shortening, the treatment of choice depends of four main factors: 1. The degree of shortening: For leg length discrepancies less than 3 cm, conservative orthopedic correction is recommended. 2. The location of the shortening: Shortening of the tibia is adequately managed with a shoe or orthosis. If the femur is involved, conservative methods are less satisfactory because they place the knees at different levels and affect the length of the stride. 3. The condition of the soft tissues: Surgical lengthening is nor recommended in the presence of extensive cutaneous and soft-tissue scarring. 4. The age and sex of the patient: In juvenile patients and women concerned with cosmesis, one can be more liberal in the election of lengthening osteotomies than in adult men. A length-equalizing orthosis is much easier to use in men then in women because it is more easily concealed by clothing.