{"id":1322,"date":"2010-12-04T15:21:00","date_gmt":"2010-12-04T15:21:00","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/the-child-with-a-difference-in-leg-length\/"},"modified":"2023-11-20T11:20:22","modified_gmt":"2023-11-20T11:20:22","slug":"the-child-with-a-difference-in-leg-length","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-examination-of-the-lower-extremities\/the-examination-of-children\/the-child-with-a-difference-in-leg-length\/","title":{"rendered":"The Child With A Difference In Leg Length"},"content":{"rendered":"<hr \/>\n<p><span style=\"color: #003366;\">A difference in leg length of <span style=\"color: #33cccc;\"><strong>more than 2 cm<\/strong><\/span> may be the cause of a <span style=\"color: #33cccc;\"><strong>limping gait<\/strong><\/span> of the child. The compensatory mechanism observed during the examination is a non-structural scoliosis, also referred to as functional or compensatory scoliosis. <\/span><\/p>\n<p><span style=\"color: #003366;\">Besides a <span style=\"color: #33cccc;\"><strong>dislocated hip joint<\/strong><\/span>, the causes of a difference in leg length are: a <span style=\"color: #33cccc;\"><strong>congenital abnormality<\/strong><\/span>, <span style=\"color: #33cccc;\"><strong>trauma<\/strong><\/span>, an <span style=\"color: #33cccc;\"><strong>infection<\/strong><\/span>, a <span style=\"color: #33cccc;\"><strong>tumour<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>paralysis<\/strong><\/span>. An apparent difference in leg length may be seen in the case of <span style=\"color: #33cccc;\"><strong>severe structural scoliosis<\/strong><\/span> and, for example, in the case of contractures of the hip, knee and\/or ankle. This is observed when the <span style=\"color: #33cccc;\"><strong>block test<\/strong><\/span> is performed as the original difference in leg length remains.<\/span><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Test For The Presence Of Pelvic Asymmetry Without Any Difference In Leg Length<\/strong><\/span><\/h3>\n<p><span style=\"color: #003366;\">This test is only useful if the child can already stand and if pelvic asymmetry was noted.<\/span><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Ask the child to sit on the examination table with the legs dangling.<\/span><\/li>\n<li><span style=\"color: #003366;\">Palpate the <span style=\"color: #33cccc;\"><strong>anterior superior iliac spine<\/strong><\/span> (<em>ASIS<\/em>) with the thumbs and assess at eye level whether these are at the same height. <\/span><\/li>\n<li><span style=\"color: #003366;\">If this is not the case there is pelvic asymmetry, which could be a consequence of an <span style=\"color: #33cccc;\"><strong>adduction contracture<\/strong><\/span> or an <span style=\"color: #33cccc;\"><strong>asymmetric pelvis<\/strong><\/span> (<em>e.g. after poliomyelitis<\/em>) or <span style=\"color: #33cccc;\"><strong>structural<\/strong><\/span> (<em>in particular paralytic<\/em>) <span style=\"color: #33cccc;\"><strong>scoliosis<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">If both ASIS are at the same height in this situation, there is pelvic asymmetry due to a different in leg length, and the general leg length test and the block test should be performed. <\/span><\/li>\n<li><span style=\"color: #003366;\">In addition, it is important to determine whether the leg that is too short is really too short or whether the other leg is too long. Which part of the leg is too short should also be established.<\/span><\/li>\n<\/ul>\n<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Test To Compare Span And Height<\/strong><\/span><\/h3>\n<p><span style=\"color: #003366;\">This test should be performed if you observed a difference in leg length and have corrected this using blocks under the leg that is too short.<\/span><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">The child should stand up straight, with blocks under the leg that is too short so that the pelvis is once again horizontal (<em>the anterior superior iliac spines should be at the same height<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Measure the height of the child in this position.<\/span><\/li>\n<li><span style=\"color: #003366;\">Next, have the child spread their arms as far as possible in the horizontal plane and use a measuring tape to measure the distance between both middle fingers (<em>the arm span<\/em>).<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">The shorter leg is too short if the <span style=\"color: #33cccc;\"><strong>arm span<\/strong><\/span> is virtually <span style=\"text-decoration: underline;\">the same<\/span> as the body length. The longer leg is too long if the <span style=\"color: #33cccc;\"><strong>arm span<\/strong><\/span> is <span style=\"text-decoration: underline;\">less than<\/span> the body length. In other words: the span is normally about the same as the height.<\/span><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A difference in leg length of more than 2 cm may be the cause of a limping gait of the child. The compensatory mechanism observed during the examination is a non-structural scoliosis, also referred to as functional or compensatory scoliosis. Besides a dislocated hip joint, the causes of a difference in leg length are: a [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[72],"tags":[144],"class_list":["post-1322","post","type-post","status-publish","format-standard","hentry","category-the-examination-of-children","tag-the-examination-of-the-lower-extremities"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Child With A Difference In Leg Length - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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