Functional Scoliosis Caused by Leg Length Discrepancy
The aim of the study was to assess the possibility of correction of spine functional curvature and potential real equalisation of LLD.
369 children with functional scoliosis caused by LLD, were treated with an internal shoe lift. Only in 4 cases were external heel lifts applied.
The thickness of the internal shoe lift (or external heel lift) was selected by measuring the discrepancy with blocks of thickness from 0.5 cm to 2 cm.
The children had a follow-up examination 2 weeks after application of the shoe lift in which correction of the spine and occurrence of pain were assessed.
The next follow-up examinations were performed every 3 months until equalisation of the extremities or growth completion by the patient.
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The last follow-up examination was performed 3 months after limb equalisation and removal of the shoe lift.
Static load of extremities was measured in all children on an electronic balance specially constructed for this purpose.
The results of the study demonstrated a significant increase in static load of the longer extremity (from 5% to 28%) on average by about 12.5%.
The increased load of the shorter limb directly after application of an internal shoe lift was on average 22% (from 5% to 41%).
This phenomenon is associated with mechanisms compensating the posture including sense of equilibrium.
The increase of load along the long axis causes stimulation of chondrocyte proliferation in the epiphyseal cartilage and stimulation of bone growth.
On the other hand, the decrease of axial load inhibits bone growth.
The study concluded that medical treatment for LLD requires application of external equalisation as LLD equalisation results in elimination of scoliosis.
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References:
- Jan W. Raczkowski, Barbara Daniszewska, Krystian Zolynski (2010) Functional scoliosis caused by leg length discrepancy. Archives of Medical Science: June 30, 2010, Vol. 6, No. 3, pp. 393-398. doi: 10.5114/aoms.2010.14262
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