Department of Orthopaedics, University of Maryland School of Medicine, University of Maryland Limb Preservation and Deformity Correction Fellowship, 2200 Kernan Drive, Baltimore, MD 21207, USA.
University of Maryland Limb Preservation and Deformity Correction Fellowship, 2200 Kernan Drive, Baltimore, MD 21207, USA.
Clin Podiatr Med Surg. 2022 Jan;39(1):113-127. doi: 10.1016/j.cpm.2021.09.004.
Limb length inequality or discrepancy (LLD) occurs when there is a difference in length between 2 limbs or when deviation exists from a normally expected length for a given age. The magnitude of the discrepancy is defined as the difference between the 2 extremities. Aside from congenital etiologies, LLD can also arise from infection, paralysis, tumors/neoplasm, and surgery. Approximately 70% to 90% of the world's population has some elements of LLD with compensation allowing for tolerance and potentially masking the extent to which one limb could be significantly shorter either functionally or structurally. Components of functional LLD could include congenital shortening of soft tissues, joint contractures, axial skeleton malalignment, and abnormal pedal biomechanics (ie, posterior tibial tendonitis or equinovarus). In accordance with literature reports, most individuals can tolerate upwards of a 2 cm discrepancy. Although a constellation of symptoms such as joint pain, arthritis, alterations in oxygen consumption/heart rate, and low back pathology can occur later on in adulthood, the focus in this review will be with early diagnosis and management in the pediatric population.
肢体长度不等或差异（LLD）是指两条肢体之间存在长度差异，或者给定年龄的肢体长度与正常预期长度存在偏差。差异的大小定义为两个肢体之间的差异。除了先天性病因外，LLD 还可能由感染、瘫痪、肿瘤/肿瘤引起，和手术。大约 70%到 90%的世界人口有一些 LLD 的元素，代偿允许容忍，并且可能掩盖一条肢体在功能上或结构上明显较短的程度。功能性 LLD 的组成部分可能包括软组织先天性缩短、关节挛缩、轴向骨骼对线不良和足部生物力学异常（即，后胫骨肌腱炎或马蹄内翻）。根据文献报道，大多数人可以耐受超过 2 厘米的差异。尽管在成年后可能会出现一系列症状，如关节疼痛、关节炎、耗氧量/心率改变和下腰痛，但本综述的重点将是儿科人群的早期诊断和管理。
