Recommendations for the follow-up of children with leg length discrepancy: expert consensus

Abstract

Leg length discrepancy is when the length of one leg is different from the other, and is a common reason for consultation at the pediatrician's and pediatric orthopedist's office. The objective of this study was to develop recommendations for the follow-up, pre-surgical planning, and treatment of children with leg length discrepancy based on expert consensus. Material and methods. The Delphi method was used. A coordinating group selected a panel of experts, designed and analyzed each of the rounds of consultations. Semistructured questionnaires were sent by personalized e-mail. Agreement among experts ≥ 80 % was established as the criterion for consensus. At each round of consultation, non-consensual aspects were reformulated and new aspects suggested in the previous round were included. A measure of stability to conclude the consultation was determined when more than 70 % of experts sustained their opinion in successive rounds. Results. Eight experts in orthopedics and six experts in imaging studies participated. After three rounds of consultations, consensus was reached in terms of 39 recommendations for follow-up, pre-surgical planning, and treatment. These were reorganized into 32 final recommendations. Conclusions. These are the first recommendations for the follow-up of children with leg length discrepancy agreed by expert consensus.

Motorized Leg Length Discrepancy Measure: A New Device for Clinical Use – A Cross-sectional Study

“…For example, CT scanogram is the best method to measure LLD when knee flexion is greater than 30 degree (18). Otherwise, the results of radiologic studies were similar (18)(19)(20)(21). Furthermore, there is no difference between standing and supine radiologic measurements in lower limbs in the case of mechanical axis deviation less than 20mm (20).…”

“…In previous studies, the accuracy of radiologic methods has been reported and compared. For example, CT scanogram is the best method to measure LLD when knee flexion is greater than 30 degree (18). Otherwise, the results of radiologic studies were similar (18)(19)(20)(21).…”