Limb length discrepancy in congenital talipes equinovarus.

A retrospective analysis was performed to establish the prevalence and clinical significance of limb length discrepancy in congenital talipes equinovarus. Of 536 patients with the diagnosis of congenital talipes equinovarus, 259 were unilaterally affected and 277 bilaterally affected. Fifty-eight patients were identified with limb length discrepancy greater than 0.5 cm. Forty-six patients had unilateral foot deformity and in 12 cases that was bilateral. This represented a prevalence of documented limb length discrepancy in 18% of unilateral cases and 4% of bilateral cases. The discrepancy resulted in a surgical procedure to equalize the limb lengths in fourteen unilateral cases (5%). A further six unilateral cases were deemed likely to require limb length equalization, increasing the rate to 8%. Only three bilateral cases required or will require surgery for equalization (1%). There was a weak but significant correlation between the number of operations undergone and the magnitude of discrepancy. The tibia was as important in its contribution to the shortening in these patients as the foot. A total of 89% unilateral cases studied had at least 0.3 cm of tibial shortening and 43% had ipsilateral femoral shortening of at least 0.3 cm.