Residual shortening of limb after Legg-Calve-Perthes disease with different treatment modalities

Introduction: The residual shortening of limb is the major cause of gait disturbances in Legg-Calre-Perthes (LCP) disease.This study was a probing of limb length discrepancy after puberty by perfect method of teteroentgenogram in these patients. Material and Methods: Residual shortening was measured by above method following completion of skeletal maturity in 46 patients and then the data were analyzed by computerized method. The patients were divided into three equal groups that they were treated by varus femoral osteotomy (FVO), abduction orthosis (AO) and untreated, respectively. Results: The residual shortening was significantly more in AO group than FVO group and it was surprisingly a little more than the untreated group. The length of femur was identical in three groups (12.5, 11.1 and 10.4 millimeters, respectively). The length of ipsilateral tibia was significantly different (2.8 mm shortening for AO group, 1.6 mm lengthening for FVO group and 1mm lengthening for untreated group). Conclusion: Overgrowth of ipsilateral tibia seems to be the leading cause of less limb discrepancy in FVO group and disuse atrophy seems to be the major reason for significant discrepancy in AO group which was somehow worse than untreated patients.