Leg length Flashcards
anatomical leg length diff def
when a physical shortening of a unilateral lower limb exists between the head of the femur and the ankle mortise.
functional leg length diff def
Functional, or apparent, limb length inequality can be described as a unilateral asymmetry of the lower extremity without any concomitant shortening of the osseous components of the lower limb
when is a leg length discrepancy considered moderate or severe
30-60 mod
60 is severe
prevalence range in leg length discrepancy
4-95%
giles and taylor - scoliosis and LLI
functional correction occurred with a heel lift (worked in younger age, older age had a wedge shaped VB)
when the difference was > 9 mm there was a scoliotic curve, convex to the short limb side (left side)
scoliosis and LLI - the lumbar convexity occurs towards which side?
the short limb side (Hoikka et al, said that may occur on the side of the longer limb)
Holmes - IT band syndrome and LLI
7 of 61 cyclicts with knee pain and ITBS also had a leg legnth inequality..
this is irrelevant
Subotnick IT band syndrome and LLI
ITBS manifests on shorter limb side
this is so stupid
LLI and achilles tendinopathy, relevant?
no sir
stress fractures and LLI?
Friberg in finnish army people, doesn’t seem related
LLI and scitatica
LLI and scitatica
LLI and trochanteric bursitis
more likely on short side?
gold standard for LLI diagnosis
x-ray, but people will also use scanogram sometimes because it has less error than xray
four “direct” measures of LLI
- ASIS to medial malleolus
- ASIS to lateral malleolus
- Xiphoid process to medial malleolus
- Umbilicus to medial malleolus
What did Mann et al say about LLI measurements
no correlation between percentage body fat and differences in rater agreement of LLI
how many direct meethods sources of error
6
- Proximal landmark Right
- Proximal landmark Left
- Distal landmark Right
- Distal landmark Left
- Measurement Right
- Measurement Left
Ross’ method for indirect measurement that he likes
shimming with heel lifts (because palpation and visual estimate is not reliable)
most clinically useful way for measuring LLI
the indirect method
no matter what is happening in the pelvis, what will be shorter on the short limb side (anatomical difference)
greater trochanter will be lower
height of heel lift max for typical shoes
useful up to 12.55mm
how long between weeks of changing for lift therapy
every 2 weeks, change should be between 3 to 6mm
what % of people got better with heel lift by Friberg
88%
