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Unilateral discrepancy

INTRODUCTION

Shortening of the bone can be unilateral, resulting in a discrepancy in limb length.

At the level of the upper limb, a small discrepancy in the length of the arm or forearm usually has no effect on function.

At the lower limb, however, even a discrepancy of 2 to 3 cm in the length of the thigh or the leg will induce a limp. In addition, a shortening of the lower limb will tilt the pelvis to one side, inducing a spine curvature or scoliosis, which can cause lumbar pain.

Two types of shortening can occur: in a single bone (isolated, intercalary, or terminal), which is usually caused by trauma, or in more than one bone (longitudinal), which occurs from birth or as a result of alterations in growth caused by trauma.

Patients with congenital shortening primarily have longitudinal shortening; i.e., the femur accounts for most of the shortening, with less shortening in other leg bones.

Unilateral congenital shortening of the lower limbs may result in the following:

  • Congenital short femur, or Proximal Femoral Focal Deficiency
  • Fibular hemimelia
  • Tibial hemimelia
  • Foot deformity resulting in a deformed foot (varus-equinus foot, clubfoot)

  • Common Discrepancy
    Congenital Short Femur - PFFD
    Fibular Hemimelia
    Tibial Hemimelia