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An improved spreadsheet for calculating limb length discrepancy and epiphysiodesis timing using the multiplier
1School of Medicine, Loma Linda University, 11175 Campus St, Loma Linda, CA, 92350, USA. gmills@llu.edu.
Journal of Children'S Orthopaedics
|July 1, 2016
Summary
This study presents an improved Excel spreadsheet for predicting pediatric limb length discrepancy (LLD) at skeletal maturity. The tool enhances accuracy and user-friendliness for calculating LLD and timing epiphysiodesis, aiding clinical documentation.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Biomechanical analysis
Background:
- Limb length discrepancy (LLD) is a common pediatric orthopedic condition.
- Accurate prediction of LLD at skeletal maturity is crucial for treatment planning, including epiphysiodesis.
- Existing tools for LLD prediction and epiphysiodesis timing can be cumbersome or prone to error.
Purpose of the Study:
- To develop and validate an improved Excel spreadsheet for predicting limb length discrepancy (LLD) at skeletal maturity in pediatric patients.
- To enhance the efficiency and user-friendliness of LLD calculations and epiphysiodesis timing.
- To facilitate data integration into electronic medical records (EMRs).
Main Methods:
- A critical review of existing LLD prediction tools was conducted to identify limitations.
- An improved Excel spreadsheet was developed incorporating patient age, sex, limb lengths, and prior lengthening surgeries.
- The spreadsheet's accuracy and usability were compared against manual calculations and other multiplier tools.
Main Results:
- The developed spreadsheet accurately predicts LLD at skeletal maturity and optimal timing for epiphysiodesis.
- The tool incorporates functions for calculating predicted leg lengths after previous lengthening procedures.
- Concise, single-page worksheets are provided for developmental LLD, congenital LLD, and height prediction.
Conclusions:
- The updated Excel spreadsheet offers a more efficient and user-friendly method for calculating LLD and timing epiphysiodesis.
- The spreadsheet's output can be easily pasted into EMRs, improving documentation efficiency.
- This tool is recommended for both clinical practice and educational purposes in pediatric orthopedics.

