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.