MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot

Indexed/Abstracted in: EMBASE, Scopus

REVIEW  NEWS FROM THE ORTHOPEDIC TRAUMATOLOGY UNIT OF THE UNIVERSITY OF FLORENCEFREE

Medicina e Chirurgia della Caviglia e del Piede 2017 December;41(3):75-85

DOI: 10.23736/S2284-2993.17.01766-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: Italian

Lower limbs heterometry

Marco BARDELLI ✉, Guido BARNESCHI, Matteo IERI, Giuseppe SCARFÌ, Carlo VENEZIANI

Società Interdisciplinare Piede e Postura, Montecatini Terme, Pistoia, Italy

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The article defines and analyzes the incidence of lower limb heterometry in small inequalities (<3 cm). When length inequality is related to the skeletal segment of the lower limbs, it is referred to as anatomical heterometry or anatomical leg length inequality. When the difference in length is due to pathologies affecting joints and/or skeletal districts contiguous to the affected limb, or when muscular function is impaired even in positions in which no pressure is put on them in terms of body weight, this is referred to as functional heterometry or functional leg length inequality. This review analyzes lower limb heterometry below 3 cm both in static terms, by considering its effects on the spinal column and the mechanisms of compensation it produces, and in dynamics terms during walking and running. A postural alignment alteration at pelvis or torso level can only be induced by a difference in limb length of 20 mm or more. However, with alternations under 15 mm postural adjustments can be observed, and a heterometry of over 5 mm can cause can cause pelvic humps which can be observed during dorsal anterior flexion. It is still unclear whether it is adequate to prescribe a compensation lift at an age of physical growth and development; in any case, is partial compensation lifts (around two-thirds) are recommended in asymmetries above 1 cm. In adults, there are no univocal evidences on the benefits of using compensations lifts, and every case should be evaluated separately.

KEY WORDS: Leg length inequality - Developmental bone diseases - Scoliosis - Posture