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A COMPARISON OF VARIOUS CLINICAL METHODS FOR THE ASSESSMENT OF LEG LENGTH DISCREPANCIES IN CHILDREN



Abstract

At Sheffield Children’s Hospital 40 children with leg length discrepancies (caused variously by sepsis, trauma, hemihypertrophy, congenital longitudinal deficiencies) were assessed using three clinical methods: measuring blocks in the standing erect position, supine measurement from the anterior superior iliac spine to the medial malleolus, and prone measurement with the knees flexed, which allowed separate measurement of femoral and tibial discrepancies. All were then subjected to comparative CT scanogram.

The mean age of the 24 boys and 16 girls was 10 years (5 to 16). Children with abnormal pelvic architecture or a fixed pelvic obliquity were excluded from the study. The mean clinical length discrepancy was 29 mm (0 to 80 mm). The mean CT scanogram measurement was 26.4 mm (0 to 75 mm). The mean difference between clinical measurements taken prone and CT scanogram measurements was only 3.6 mm (0 to 14). There was little difference in the accuracy of measuring femoral and tibial discrepancies clinically or by CT scanogram. The prone method of measurements is a useful adjunct to Staheli’s rotational profile in the prone position.

The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.