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Review Question - QID 6156

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QID 6156 (Type "6156" in App Search)
A 12-month-old boy has right congenital fibular intercalary hemimelia with a normal contralateral limb. A radiograph of the lower extremities shows a limb-length discrepancy of 2 cm. All of the shortening is in the right tibia. Assuming that no treatment is rendered prior to skeletal maturity, the limb-length discrepancy will most likely

remain 2 cm at maturity.

11%

75/663

decrease slowly until the limb lengths equalize.

2%

15/663

increase at a constant rate of 2 cm per year.

10%

64/663

increase markedly because of complete failure of tibial growth.

17%

114/663

increase slowly, with the right lower extremity remaining in proportion to the left lower extremity.

59%

391/663

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Many congenital limb deficiencies and bowing deformities result in growth retardation. If unilateral, a gradually progressive limb-length discrepancy will result; however, the proportional lengths of the lower extremities will remain at a relatively constant ratio. For example, if the right foot is at the level of the left knee at birth, this will still be true at maturity. This concept can be useful for early prediction of limb-length discrepancy by using a “multiplier method,” as described by Paley and associates. This method can facilitate early treatment decisions, such as the need for amputation, without having to wait for serial scanography measurements.

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