[Current treatment of lower limb length inequality in children and adolescents].

Abstract

The main causes of inequality of lower limb length are reviewed. In children, prediction of final inequality is difficult; accurate determination of bone ange and rigorous clinical and roentgenographic measurements should be repeated yearly. Surgical procedures are improving but remain less than ideal. Desepiphysiodesis, the only etiological treatment of growth plate sterilization, has a success rate of no more than 40%. Epiphysiodesis is reliable but the optimal bone age at which it should be performed is difficult to determine. Gradual lengthening techniques have changed considerably over the last five years; although the current slower, more rational methods provide higher healing rates within 40 days per centimeter gained, the complication rate remains at least 50% even in units with extensive experience. Such procedures should be used only in substantial inequalities after full information of the family about the significant rate of complications which often escape prediction.