Epiphysiodesis for limb length inequality: results and indications

In view of the minimum morbidity, low incidence of complciations, and averall success rate, epiphysiodesis is an excellent method for correction of moderate limb length discrepancies. Skeletally immature patients with discrepancies between 2.5-8 cm with adult height predicted to be in the normal range (5 feet or greater) are good candidates for epiphysiodesis. Preoperative evaluation over several years prior to operation, utilizing the principles of Green-Anderson or the straight line graph, provide an accurate means of predicting future growth and determination of time of operation. Technique of epiphysiodesis is reliable and technical complications resulting from its use are few. Patient with a paralytic basis for shortening do best functionally with an end result undercorrection of 1.5 cm; equalization or overcorrection is to be avoided in these patients. Nonparalytic patients do best if limb lengths are equalized, with 1.5 cm of overcorrection or under-correction equally well tolerated.