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[Anisomelia. Clinical consequences and treatment]
H Steen1, T Terjesen, I Bjerkreim
1Rikshospitalet, Senter for Ortopedi Universitetet i Oslo.
Summary
Unequal leg length, especially over 1 cm, is linked to low back pain. Adjusting this discrepancy, particularly with scoliosis, is recommended for symptomatic individuals.
Area of Science:
- Orthopedics and Sports Medicine
- Biomechanics
Context:
- A significant association exists between leg length discrepancy (LLD) and low back pain.
- Radiographic evidence of lumbar scoliosis can be linked to LLD.
Purpose:
- To investigate the clinical significance of leg length discrepancy.
- To provide guidance on managing LLD based on severity and symptoms.
Summary:
- While a direct causal link remains challenging to prove, an LLD exceeding 1 cm is scientifically documented to associate with low back pain.
- Management strategies vary: shoe raises for discrepancies under 2 cm, and surgical interventions (epiphysiodesis, osteotomy) for larger differences.
- Pre-operative shoe raise testing is advised for adults with moderate LLD to assess functional improvement before surgery.
Impact:
- Highlights the importance of addressing LLD for musculoskeletal health.
- Informs clinical practice regarding the diagnosis and treatment of LLD-related pain.
- Provides evidence-based recommendations for conservative and surgical management of LLD.
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