Leg-length discrepancy and bone age in unilateral idiopathic talipes equinovarus

The goals of this retrospective review were to evaluate leg-length discrepancy in patients with a unilateral clubfoot and to determine the relationship between bone age and chronologic age in the same population. Thirty-two of 47 patients referred for scanograms had a discrepancy more than 0.5 cm. Shortening was predominantly in the tibia, and four patients had radiographic evidence of growth disturbance. Five had been treated surgically at the time of review. If clinically indicated, a scanogram and standing radiographs of the ankle are necessary to determine the location and magnitude of discrepancy. Although the literature supports a neurologic etiology in some patients, and bone age may be delayed in certain neuromuscular conditions associated with limb shortening (hemiplegia), the authors' results suggest that bone age is statistically equivalent to chronologic age in the unilateral clubfoot population. These findings do not provide indirect support for a neurologic etiology.