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[Pelvic tilt and leg length discrepancy].

F Grill1, M Chochole, A Schultz

  • 1Orthopädisches Spital Wien-Speising.

Der Orthopade
|September 1, 1990
PubMed
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Leg length discrepancy causing pelvic obliquity can be effectively treated with surgical interventions like bone lengthening or shortening osteotomies. Modern techniques improve outcomes, restoring symmetry and function, avoiding lifelong assistive devices.

Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Surgical Innovation

Background:

  • Pelvic obliquity due to leg length discrepancy (LLD) affects patients with diverse conditions.
  • Treatment decisions are primarily guided by the degree of LLD and leg growth patterns, not the underlying cause.

Purpose of the Study:

  • To analyze the outcomes of surgical interventions for pelvic obliquity caused by LLD.
  • To evaluate the effectiveness of different surgical techniques, including shortening, lengthening, and distraction procedures.

Main Methods:

  • Retrospective analysis of 345 patients with pelvic obliquity due to LLD operated on between 1969 and 1989.
  • Procedures included shortening (146 patients), lengthening (199 patients), and distraction procedures (134 patients/138 segments) using Wagner, Ilizarov, or Orthofix devices.

Related Experiment Videos

  • Biological bone growth stimulation was attempted in 65 cases.

    • Main Results:

    • Excellent results were achieved in 65% of cases, with good results in 23%. The condition worsened in 12%.
    • Distraction procedures showed varying success rates depending on the device used (Wagner, Ilizarov, Orthofix).
    • Modern lengthening techniques and external fixation systems have enhanced safety and efficacy.

    Conclusions:

    • Epiphysiodesis, shortening osteotomies, and bone lengthening are justified for LLD with clear indications.
    • Treatment strategies vary by discrepancy magnitude: conservative for <2-3 cm, epiphysiodesis/shortening for 3-5 cm, and lengthening for 5-15 cm.
    • Accurate assessment and planning, often involving combined lengthening and shortening, can restore symmetry and function, preventing the need for lifelong assistive devices.