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A 13-year-old boy presents with a leg-length discrepancy with the right leg shorter than the left. He has normal height for his age and his skeletal age is equal to his chronologic age. History and examination of Tanner staging reveals that he began puberty 1 month ago. His final leg length discrepancy at skeletal maturity is projected to be 4.0cm. Which of the following surgical options is the most appropriate?
Physeal stapling of the medial left tibial and femoral physis now with staged removal of staples at age 16
Immediate lengthening of the right femur with ring external fixator
Epiphysiodesis of the left femur 1 year after the onset of puberty
Epiphysiodesis of the left femur and tibia 6 months from now
Epiphysiodesis of the bilateral femurs and shortening of the left tibia now
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At what age does longitudinal growth usually arrest in boys at the distal femur physeal growth plate?
A 9-year-old girl presents with a history of juvenile rheumatoid arthritis, and a 20 degree flexion contracture of her left knee. A clinical photo is shown in Figure A. Which of the following is the most accurate method of determining leg length discrepancy in this patient?
A 14-year-old boy sustains a significant distal femoral physeal fracture. Assuming that he has a complete growth arrest, what is the predicted leg length discrepency?
A 14-year-old boy has complete growth arrest of his left proximal tibia after a skateboarding injury. He currently has a 3mm leg-length discrepancy with left shorter than the right. A radiograph of the patients left hand, wrist, and fingers demonstrate a bone-age of 14 years. What is the most appropriate management of this patient?
Left tibial lengthening
Right tibia epiphysiodesis
Right femur epiphysiodesis
A 14-year-old male patient with a leg-length discrepancy undergoes a distal femoral and proximal tibial epiphysiodesis on the longer leg. What is the anticipated amount of correction achieved with this procedure in this child?
A 9-year-old male sustains the fracture seen in Figure A. If a complete growth arrests occurs, his expected leg length discrepancy at skeletal maturity would be?
HPI - This is the case of a 10 month old girl with a hypotrophic malformation syndrome of the left half of the body.
She has thumb duplication with a second inter-digital space angle of about 80 degrees, a radial club hand, and a hypoplastic radius.
Hallux duplication deviated 88 degrees medially, tibia hypoplasia with a 3 cm leg length discrepency.
She underwent surgical treatment (by non-expert hands) of these duplications without correcting the deviations. She is now 7 months post-op.
Do you think that this is Silver-Russell syndrome?
HPI - 25 yr female presented with rt lateral pelvic tilt,thigh adduction,internal rotation and tight rt hamtrings since childhood underwent adductor release plus hamstring release and derotation osteotomy 6 months ago,pelvic tilt improved(3cm on standing,5cm supine), patient now wear 1.8cm shoe lift and still have limping
What is the best treatment method to correct limp length inequality?