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Leg length discrepancy in patients with slipped capital femoral epiphysis
Seung-Ju Kim1, Tamir Bloom, Sanjeev Sabharwal
1Department of Orthopaedics, New Jersey Medical School, Newark, NJ, USA. sju627@hotmail.com
Background And Purpose:
Leg-length discrepancy (LLD) can be a sequela of slipped capital femoral epiphysis (SCFE). We tried to identify factors that affect the development of LLD following SCFE.
Patients And Method:
We evaluated 85 patients who had been treated using percutaneous screw fixation. The average age of the patients at the time of surgery was 12 (8-16) years. The relationship of LLD and various clinical and radiographic parameters was evaluated: the degree of slip, articulotrochanteric distance (ATD), and articulotrochanteric distance difference (ATDD) (healthy side minus the side with SCFE). We assessed the relationship between ATDD and LLD based on scanogram.
Results:
The average LLD was 1.4 (0.1-3.8) cm at 6 (2-15) years postoperatively. 48 of 85 patients had an LLD of greater than 1 cm and 10 patients had an LLD of greater than 2 cm. There was a correlation between the magnitude of LLD and the severity of the slip. There was no statistically significant correlation between LLD and the stability of the slip, age, BMI, sex, or race. There was a significant correlation between LLD and ATDD.
Interpretation:
Patients with a high degree of slip are prone to develop clinically significant LLD. Although ATDD does not give the exact LLD, it can be used as a primary measurement, which should be supplemented with scanogram in cases of clinically significant differences in length.
