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腿长差异:完整病史和检查的重要性。

Leg length discrepancy: the importance of a complete history and examination.

作者信息

Coffey Duncan, Hudson-Phillips Sarah Patricia, Radha Sarkhell Saadi, Ball Simon

机构信息

Trauma and Orthopaedics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

General Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.

出版信息

BMJ Case Rep. 2017 Dec 2;2017:bcr-2017-220985. doi: 10.1136/bcr-2017-220985.

Abstract

A 26-year-old woman with a 1-year history of right knee pain had failed to respond to analgesia and activity modification in the community. Her general practitioner referred her to the orthopaedic department for specialist review. A thorough history revealed that she had multiple orthopaedic interventions as a child. The patient had significant postoperative infection of the left knee following knee surgery at 7 years of age. Examination demonstrated the presence of a limp, scoliosis and suspected leg length discrepancy. Plain film radiography confirmed the presence of leg length discrepancy, with the right limb measuring 30 mm longer than the left. The leg length discrepancy was likely secondary to a growth arrest of the left knee following the postoperative infection in childhood. The patient was managed with physiotherapy and heel raises and received regular orthopaedic follow-up.

摘要

一名有1年右膝疼痛病史的26岁女性,在社区接受镇痛和调整活动方式治疗后未见好转。她的全科医生将她转诊至骨科进行专科检查。详细的病史显示,她小时候接受过多次骨科手术。该患者7岁时膝关节手术后左膝发生严重的术后感染。检查发现有跛行、脊柱侧弯,怀疑存在腿长差异。X线平片证实存在腿长差异,右下肢比左下肢长30毫米。腿长差异可能是由于童年时期术后感染导致左膝生长停滞所致。该患者接受了物理治疗和垫高鞋垫治疗,并定期接受骨科随访。

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