Tumblelog by Soup.io
Newer posts are loading.
You are at the newest post.
Click here to check if anything new just came in.
cantulrfdngziwa

Leg Length Discrepancy After Hip Replacement Pain

http://cantulrfdngziwa.soup.io Overview

There are many different conditions in childhood and adult life that can lead to deformity of a limb or difference in leg lengths. Treatment for these conditions depends on the condition being treated, the age of the child and the amount of deformity or shortening. Generally, only a final difference of leg length of 2cm or more requires surgical treatment. An outline of treatment options is given below.Leg Length Discrepancy

Causes

From an anatomical stand point, the LLD could have been from hereditary, broken bones, diseases and joint replacements. Functional LLD can be from over pronating, knee deformities, tight calves and hamstrings, weak IT band, curvature in the spine and many other such muscular/skeletal issues.

Symptoms

Children whose limbs vary in length often experience difficulty using their arms or legs. They might have difficulty walking or using both arms to engage in everyday activities.

Diagnosis

Leg length discrepancy may be diagnosed during infancy or later in childhood, depending on the cause. Conditions such as hemihypertrophy or hemiatrophy are often diagnosed following standard newborn or infant examinations by a pediatrician, or anatomical asymmetries may be noticed by a child's parents. For young children with hemihypertophy as the cause of their LLD, it is important that they receive an abdominal ultrasound of the kidneys to insure that Wilm's tumor, which can lead to hypertrophy in the leg on the same side, is not present. In older children, LLD is frequently first suspected due to the emergence of a progressive limp, warranting a referral to a pediatric orthopaedic surgeon. The standard workup for LLD is a thorough physical examination, including a series of measurements of the different portions of the lower extremities with the child in various positions, such as sitting and standing. The orthopaedic surgeon will observe the child while walking and performing other simple movements or tasks, such as stepping onto a block. In addition, a number of x-rays of the legs will be taken, so as to make a definitive diagnosis and to assist with identification of the possible etiology (cause) of LLD. Orthopaedic surgeons will compare x-rays of the two legs to the child's age, so as to assess his/her skeletal age and to obtain a baseline for the possibility of excessive growth rate as a cause. A growth chart, which compares leg length to skeletal age, is a simple but essential tool used over time to track the progress of the condition, both before and after treatment. Occasionally, a CT scan or MRI is required to further investigate suspected causes or to get more sophisticated radiological pictures of bone or soft tissue.

Non Surgical Treatment

Structural leg length discrepancy can be treated with a heel lift in the shorter leg?s shoe, if the leg length is greater than 5 mm. The use and size of the heel lift is determined by a physical therapist based on how much lift is needed to restore proper lumbopelvic biomechanics. In certain cases, surgical intervention may be needed to either shorten or lengthen the limb. An important component to any surgical procedure to correct leg length discrepancies is physical therapy. Physical therapy helps to stretch muscles and maintain joint flexibility, which is essential in the healing process. For a functional leg length discrepancy no heel lift is required, but proper manual therapy techniques and specific therapeutic exercise is needed to treat and normalize pelvic and lower extremity compensations. The number of treatments needed to hold the pelvis in a symmetrical position is different for each patient based on their presentation and biomechanical dysfunctions in their lower back, pelvis, hip, knee, and foot/ankle. If you have pain in your lower back or lower extremity and possibly a length discrepancy; the two symptoms could be related. A good place to start would be a physical therapy evaluation to determine whether you have a leg length discrepancy and if it could be contributing to your lower back pain, hip pain, knee pain, or leg pain.

Leg Length Discrepancy

shoe lifts for men's shoes

Surgical Treatment

Surgical options in leg length discrepancy treatment include procedures to lengthen the shorter leg, or shorten the longer leg. Your child's physician will choose the safest and most effective method based on the aforementioned factors. No matter the surgical procedure performed, physical therapy will be required after surgery in order to stretch muscles and help support the flexibility of the surrounding joints. Surgical shortening is safer than surgical lengthening and has fewer complications. Surgical procedures to shorten one leg include removing part of a bone, called a bone resection. They can also include epiphysiodesis or epiphyseal stapling, where the growth plate in a bone is tethered or stapled. This slows the rate of growth in the surgical leg.

Don't be the product, buy the product!

Schweinderl