Dg. Little et Md. Aiona, LIMB LENGTH DISCREPANCY IN CONGENITAL TALIPES EQUINOVARUS, Australian and New Zealand journal of surgery, 65(6), 1995, pp. 409-411
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.