Sabharwal Sanjeev, Kumar Ajay
Division of Pediatric Orthopaedics, Department of Orthopaedics, UMDNJ-New Jersey Medical School, Newark, NJ, USA.
Clin Orthop Relat Res. 2008 Dec;466(12):2910-22. doi: 10.1007/s11999-008-0524-9. Epub 2008 Oct 4.
The use of accurate and reliable clinical and imaging modalities for quantifying leg-length discrepancy (LLD) is vital for planning appropriate treatment. While there are several methods for assessing LLD, we questioned how these compared. We therefore evaluated the reliability and accuracy of the different methods and explored the advantages and limitations of each method. Based on a systematic literature search, we identified 42 articles dealing with various assessment tools for measuring LLD. Clinical methods such as use of a tape measure and standing blocks were noted as useful screening tools, but not as accurate as imaging modalities. While several studies noted that the scanogram provided reliable measurements with minimal magnification, a full-length standing AP computed radiograph (teleoroentgenogram) is a more comprehensive assessment technique, with similar costs at less radiation exposure. We recommend use of a CT scanogram, especially the lateral scout view in patients with flexion deformities at the knee. Newer modalities such as MRI are promising but need further investigation before being routinely employed for assessment of LLD.
Level IV, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
使用准确可靠的临床和影像学方法来量化腿长差异（LLD）对于规划适当的治疗至关重要。虽然有几种评估LLD的方法，但我们质疑这些方法之间的比较情况。因此，我们评估了不同方法的可靠性和准确性，并探讨了每种方法的优缺点。基于系统的文献检索，我们确定了42篇涉及测量LLD的各种评估工具的文章。临床方法，如使用卷尺和站立垫，被认为是有用的筛查工具，但不如影像学方法准确。虽然几项研究指出扫描图能提供可靠的测量结果且放大率最小，但全长站立前后位计算机X线片（远距X线片）是一种更全面的评估技术，成本相似且辐射暴露更少。我们建议使用CT扫描图，特别是对于膝关节有屈曲畸形的患者采用外侧定位像。像MRI等更新的方法很有前景，但在常规用于评估LLD之前还需要进一步研究。
IV级，诊断性研究。有关证据水平的完整描述，请参阅作者指南。
