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Leg Length Discrepancy M21.759 736.81

  Leg Length Discrepancy ICD-10

Leg Length Discrepancy ICD-9

  • 736.81 Unequal leg length (acquired)

  
Leg Length Discrepancy

  • proximal femur grows 2mm/yr
  • distal femur grows 9mm/yr
  • proximal tibia grows 6mm/yr
  • distal tibia =grows 4mm/yr
  • Mosely graph
  • girls generally grow to age 14, boys=16
  • distal femur accounts for 37% of total LE growth
  • proximal tibia =28% of total LE growth
  • LLD<3% not associated c compensatory walking mechanisms
  • LLD>5% difficult to compensate(toe walking etc) for
  • Leg Length Discrepancyxray
  • scanogram=hip,knee,ankle
  • orthoroentogram=3films tied together gives leg length and alignment
  • Predictiors of LLD: (Paley D, JBJS 2000;82A:1432)

Leg Length Discrepancy Treatment

  • shoe lift for <2.5cm
  • epiphysiodesis for 2.5-4cm
  • lengthening for >4cm
  • prosthesis for 30% or more shortening
  • Shoe Lift modifications are available from www.orthopedicshoelift.com. 1-888-443-3537.

Leg Length Discrepancy Differential Diagnosis

  • Fibular hemimelia
  • PFFD
  • hemihypertrophy(must U/S abdomin to r/u Wilm's tumor yearly to age 6-8)

Leg Length Discrepancy References

  • Moseley CF, ICL 1989;38:325

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