Abnormalities in the uninvolved lower limb in children with spastic hemiplegia: The effect of actual and functional leg-length discrepancy

We assessed the pattern of gait in children with spastic hemiplegia and a l eg-length discrepancy, particularly in relation to the uninvolved limb. The kinematics of the uninvolved limbs were compared with the pattern in norma l children. The uninvolved limbs in children with hemiplegia and a signific ant leg-length discrepancy were compared with the uninvolved limb in those children who did not have a leg-length discrepancy. We found that the invol ved and uninvolved legs in patients with hemiplegia had characteristic patt erns that were significantly different from normal. The kinematics of the i nvolved leg were not affected by the presence of a leg-length discrepancy. The abnormal pattern in the uninvolved limb was more exaggerated in childre n with a leg-length discrepancy. The abnormal sagittal plane kinematics in the uninvolved lower limb in hemiplegic children appears to be related to t he presence of an actual or functional leg-length discrepancy and have not previously been described. Our findings suggest that attention be paid to t he functional and actual leg-length discrepancy that exists in these childr en, and early consideration be given to epiphysiodesis of the uninvolved li mb.