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The importance of submalleolar deformity in determining leg length discrepancy

The importance of submalleolar deformity in determining leg length discrepancy
The importance of submalleolar deformity in determining leg length discrepancy
Background and purpose

The association of leg length discrepancy (LLD) with a number of clinical disorders has made its determination a significant part of the physical examination. We believe that submalleolar causes of LLD may be under-acknowledged. The most common clinical method used to measure LLD is by tape from the anterior superior iliac spine (ASIS) to medial malleolus which disregards the potential for LLD arising from asymmetry in the foot distal to the tibiotalar joint.

Methods

The present pilot study involves a group of 5 volunteers (experimental group) and a group of 3 patients with flexible flat feet (clinical study). The differences in tibial tubercle height from the ground between full pronation and full supination were measured using the CODA MPX 30® system (Charnwood Dynamics Limited, Leicestershire, England). Correlations of the patterns within each group were produced.

Results

A significant relationship with leg lengths was found in the experimental group when they induced maximum pronation (R-squared = 0.62, p = 0.007) while an inverse relationship occurred with supination, although marginally significant (R-squared = 0.37, p = 0.064).

Conclusions

We have demonstrated that significant leg length discrepancy can occur in patients who do not have obvious deformity when non weight bearing. We recommend using the blocks method routinely. Appropriately measuring LLD is of vital importance to properly diagnosing and treating patients with unequal leg lengths or related symptoms.
leg length discrepancy, measurements, 3-D gait analysis, foot position
1479-666X
201-205
Ali, A.
7ff4822c-7d13-49f5-bb78-c880e3c1be45
Walsh, M.
78b91e0c-da3f-42f3-9787-acc3699e616f
O'Brien, T.
0e6ee6ec-ebe6-474c-8a21-ed6a4ddd4068
Dimitrov, B.D.
366d715f-ffd9-45a1-8415-65de5488472f
Ali, A.
7ff4822c-7d13-49f5-bb78-c880e3c1be45
Walsh, M.
78b91e0c-da3f-42f3-9787-acc3699e616f
O'Brien, T.
0e6ee6ec-ebe6-474c-8a21-ed6a4ddd4068
Dimitrov, B.D.
366d715f-ffd9-45a1-8415-65de5488472f

Ali, A., Walsh, M., O'Brien, T. and Dimitrov, B.D. (2014) The importance of submalleolar deformity in determining leg length discrepancy. The Surgeon, 201-205. (doi:10.1016/j.surge.2013.12.003). (PMID:24411925)

Record type: Article

Abstract

Background and purpose

The association of leg length discrepancy (LLD) with a number of clinical disorders has made its determination a significant part of the physical examination. We believe that submalleolar causes of LLD may be under-acknowledged. The most common clinical method used to measure LLD is by tape from the anterior superior iliac spine (ASIS) to medial malleolus which disregards the potential for LLD arising from asymmetry in the foot distal to the tibiotalar joint.

Methods

The present pilot study involves a group of 5 volunteers (experimental group) and a group of 3 patients with flexible flat feet (clinical study). The differences in tibial tubercle height from the ground between full pronation and full supination were measured using the CODA MPX 30® system (Charnwood Dynamics Limited, Leicestershire, England). Correlations of the patterns within each group were produced.

Results

A significant relationship with leg lengths was found in the experimental group when they induced maximum pronation (R-squared = 0.62, p = 0.007) while an inverse relationship occurred with supination, although marginally significant (R-squared = 0.37, p = 0.064).

Conclusions

We have demonstrated that significant leg length discrepancy can occur in patients who do not have obvious deformity when non weight bearing. We recommend using the blocks method routinely. Appropriately measuring LLD is of vital importance to properly diagnosing and treating patients with unequal leg lengths or related symptoms.

Text
2014_AA---BDD-Leg Submalleolar-The Surgeon (2014).pdf - Other
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More information

Published date: 2014
Keywords: leg length discrepancy, measurements, 3-D gait analysis, foot position
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 361553
URI: https://eprints.soton.ac.uk/id/eprint/361553
ISSN: 1479-666X
PURE UUID: db8e3e7c-2c12-4f0d-84bf-49c58ed3adcf

Catalogue record

Date deposited: 27 Jan 2014 15:22
Last modified: 06 Aug 2019 18:47

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