Segmental shortening and equalization for leg length discrepancies in adults

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering

Background:

• Leg length discrepancy (LLD) presents a significant challenge in young adults, potentially leading to secondary lumbar scoliosis and pain.
• Surgical intervention is often necessary for substantial LLD, but requires careful consideration of techniques and outcomes.

Purpose of the Study:

• To evaluate the efficacy and outcomes of surgical leg length equalization techniques in young adults with significant LLD.
• To assess complication rates, consolidation times, and functional recovery following surgical LLD correction.

Main Methods:

• Retrospective analysis of 8 young adult patients (ages 16-35) with LLD (2.5-12 cm).
• Surgical techniques included subtrochanteric femoral shortening, combined femoral shortening and lengthening, and diaphyseal "Z" osteotomy with shortening.
• Postoperative outcomes, including consolidation, weight-bearing, complications, residual discrepancy, scoliosis, and patient satisfaction, were assessed.

Main Results:

• Average shortening was 3.8 cm, with complete equalization in 2 cases and residual discrepancy of 0.5-2 cm in others.
• Average consolidation time was 3.4 months; full weight-bearing ranged from 2-6 months.
• One case of mild, transient extensor weakness was noted. Secondary lumbar scoliosis improved by an average of 12 degrees, with consistent relief of lumbar pain.

Conclusions:

• Surgical leg length equalization techniques are effective in correcting significant LLD in young adults.
• These procedures demonstrate a favorable safety profile, with minimal complications and high patient satisfaction.
• Correction of LLD via surgery can lead to significant improvements in associated spinal deformities and pain.