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CASE REPORT
Leg Length Discrepancy in 14F
https://upload.orthobullets.com/cases/102707/a.jpg https://upload.orthobullets.com/cases/102707/b.jpg
A
Sanjeev Sabharwal MD
UCSF Benioff Children’s Hospital
Institute for Global Orthopaedics and Traumatology
Institute for Global Orthopaedics and Traumatology
Post-Traumatic Limb Deformities in Children and Young Adults: A Global Perspective 2025
Post-Traumatic Limb Deformities in Children and Young Adults: A Global Perspective 2025
VIEW EXPERT OPINIONS
HPI
In May 2019, a 14-year-old postmenarchal female presented with a right-sided limp, leg length discrepancy, and a fixed flexion deformity of the right ... knee. Radiographic and clinical images from this presentation are shown in Figures G, H, I, J, and K, and show she has 5. 9 cm of shortening, 43 degrees of procurvatum (apex anterior), and 5 degrees of valgus deformity of the right femur. Her history is notable for a traumatic injury in November 2015, approximately 3.5 years prior, at the age of 10. While playing, another child fell on her right knee, resulting in an isolated Salter-Harris type II fracture of the distal femur. Initial injury radiographs are provided in Figures A and B. The fracture was managed with closed reduction and percutaneous pinning (CRPP). Immediate postoperative radiographs are shown in Figures C and D. The fixation hardware was removed without complications approximately six weeks postoperatively. The patient was subsequently lost to follow-up and re-presented in August 2017 with progressive angular deformity of the right knee. Radiographs at that time demonstrated premature physeal arrest of the distal femur with associated flexion deformity. She was treated with anterior hemiepiphysiodesis of the distal femoral physis. Postoperative radiographs following this intervention are shown in Figures E and F.
3287   votes
7
(P: 214634) Now that the patient presents at age 14 with a procurvatum deformity and LLD of 5.9 cm (Figure G, H, I, J K), if you choose to correct deformity + lengthen short side, would you do it in a single procedure or staged procedure?
I would not choose to correct deformity + lengthen short side
1%
3/249
Single procedure
44%
110/249
Staged - Correct deformity 1st, then length short side at later date
46%
117/249
Staged - 1st lengthen short side, then correct deformity at later date
4%
11/249
Outside my area of expertise - best if I don't vote
3%
8/249
5   Surgeons
1
Brock Browning, DO Cape Fear Orthopedics & Sports Medicine, US
TOP 5 %
Learning
United States of America
Last Week
United States of America
2
Alejandro Fuentes Salazar, MD Caja Costarricense de Seguro Social (CCSS)
TOP 5 %
Patient Care
Costa Rica
Last Week
Costa Rica
3
Michael Buchanan, MD , US
TOP 5 %
Patient Care
United States of America
Last Month
United States of America
4
Oyoo Were, MD KNH, Nairobi, KE
TOP 5 %
Patient Care
Kenya
Last Month
Kenya
5
Rodrigo Corena, MD QuironSalud Malaga
TOP 5 %
Patient Care
Spain
Last Month
Spain
63   Countries
Leaflet
1
United States of America
58 surgeons
2
Spain
16 surgeons
3
Greece
13 surgeons
4
Israel
9 surgeons
5
United Kingdom of Great Britain and Northern Ireland
8 surgeons
55   Expert Comments
Juan Varela MD
TOP 5 %
Patient Care
Spain
Last Year
Well,it’s a extreme discrepancy paired with deformity Probably I’d get length 1st over a nail and s... more
Jan Szatkowski MD
TOP 5 %
Patient Care
United States of America
Last Week
Wow—great result correcting the deformity and achieving limb lengthening. What’s your go-to method ... more
Stephen McHale
TOP 5 %
Patient Care
United Kingdom of Great Britain and Northern Ireland
Last Year
I’m curious as a non limb recon surgeon: once you’ve chosen to use a frame to address the distal fem... more
More comments
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Obstetric Brachial Plexopathy (Erb's, Klumpke's Palsy)
PMID: 14974639 Dev Med Child Neurol. 2004 Feb;46(2):138-44.
E
post

Natural history of obstetric brachial plexus palsy: a systematic review.

Willem Pondaag
Martijn J A Malessy
J Gert van Dijk
Ralph T W M Thomeer
Natural history of obstetric brachial plexus palsy: a systematic review.
Pubmed
Journal



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1   Countries
Leaflet
TOP     EXPERTS
1
Anastasios Pitsounis, MD Athens, GR
TOP 5 %
Patient Care
Greece
Last Week
Greece

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    Natural history of obstetric brachial plexus palsy: a systematic review.
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