An improved spreadsheet for calculating limb length discrepancy and epiphysiodesis timing using the multiplier...

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.