Short Leg Syndrome Flashcards
What are the two classes of functional causes of short leg syndrome?
Bony abnormalities in lumbar, innominate, and sacral base
Soft tissue abnormalities like hypertonic flexors, extensors, and adductors
5 structural causes of short leg syndrome?
Trauma, THA, TKA, Pes Planus, bow legs
3 childhood problems leading to short leg syndrome?
Salter Harris
Legg calve
Slipped capital femoral epiphysis
What is legg calve and what patient population is it most commonly seen in?
Avascular necrosis of the femoral head
Young boys
X ray sign for slipped capital femoral epiphysis?
Ice cream falling off a cone
What is one of the important goals of compensation for short leg syndrome?
To keep eyes horizontal to maintain proprioceptive input
What does L5 do with short leg syndrome?
SB towards axis of sacral torsion and rotates opposite or towards deep sulcus
How much heel lift for flexible and fragile patients For structural LLD?
Flexible: start at 1/8 inch and then add 1/8 inch every 2 weeks
Fragile: start 1/16 inch and add 1/16 every 2 weeks
What is the formula for total lift needed?
Sacral base unleveling/(Duration + compensation)
Duration: less than ten years is 1, 10-30 years is 2, and over 30 years is 3
Compensation: none is 0, L spine rotation/SB is 1 and wedding of vertebra is 2
3 rules of treatment for structural LLD?
Only when femoral head discrepancy is greater than 5 mm
Max 1/2 inch heel lift
Final lift height should be 1/2-3/4 of measured discrepancy
In the short leg, what is happening in the following structures?
Innominate, lilac crest height, sacrum, lumbar, thoracic, shoulder, foot, ankle, calcaneus, femur, knee and pelvic side shift?
Anterior rotation Low Deep sulcus SB away Concave Early high, late low Supinate Plantarflexed, inverted and adducted ER Extended Away
Superior, medal and lateral border of the femoral triangle?
Inguinal ligament
Adductor longus
Sartorius
