LIMB LENGTH DISCREPANCY IN CONGENITAL TALIPES EQUINOVARUS

A retrospective analysis was performed to establish the prevalence and clinical significance of limb length discrepancy in congenital talipe s equinovarus. Of 536 patients with the diagnosis of congenital talipe s equinovarus, 259 were unilaterally affected and 277 bilaterally affe cted. Fifty-eight patients were identified with limb length discrepanc y greater than 0.5 cm. Forty-six patients had unilateral foot deformit y and in 12 cases that was bilateral. This represented a prevalence of documented limb length discrepancy in 18% of unilateral cases and 4% of bilateral cases. The discrepancy resulted in a surgical procedure t o equalize the limb lengths in fourteen unilateral cases (5%). A furth er six unilateral cases were deemed likely to require limb length equa lization, increasing the rate to 8%. Only three bilateral cases requir ed or will require surgery for equalization (1%). There was a weak but significant correlation between the number of operations undergone an d the magnitude of discrepancy. The tibia was as important in its cont ribution to the shortening in these patients as the foot. A total of 8 9% unilateral cases studied had at least 0.3 cm of tibial shortening a nd 43% had ipsilateral femoral shortening of at least 0.3 cm.