Correction of Leg Length Discrepancy by Eplphysial Arrest

Abstract

1. A simple calculation for the timing of epiphysial arrest to correct leg length discrepancy is described. An assumption is made that growth ceases at a constant chronological age of sixteen years in boys and fourteen years in girls. It is further assumed that the lower femoral epiphysis provides three-eighths of an inch and the upper tibial epiphysis one-quarter inch of growth each year. 2. Whilst the assumptions made are known to be approximations, analysis of the results of fifty-three epiphysial arrests in forty-four children shows that the errors cancel themselves sufficiently to make this method accurate. The simplicity of the calculation makes it useful to confirm or modify the timing of arrests calculated on the basis of skeletal age, or as an alternative method.

Growth and maturation in Marfan syndrome

“…The age recommended for initiating brace treatment is earlier in MFS than the general population [Sponseller et al, 2000], which may be partly explained by the 2.4 and 2.2 year earlier peaks of linear growth velocity associated with puberty in males and females, respectively. Accurate growth charts are essential when considering interventions that alter final height, such as epiphysiodesis [Menelaus, 1966;Moseley, 1977;Horton and Olney, 1996] or hormone treatment [Zachmann et al, 1975;Skovby and McKusick, 1977;Prader and Zachmann, 1978;Bailey et al, 1981;Knudtzon and Aarskog, 1988]. In all the patients reviewed for selection for this study, less than 10 were excluded because they had received hormone treatment.…”

Lower-limb growth: How predictable are predictions?

“…Menelaus's original paper [9] used chronological age to calculate the growth remaining and assumed that growth ceases at a chronological age of 16 years in boys and 14 years in girls, thus calculating 3 years of growth from the onset of puberty. He used the original suggestion of White and Stubbins [23] that the distal femur grows at 0.9 cm/year and the proximal tibia 0.6 cm/year.…”

Untitled

“…The maximum age at the time of fracture was taken at 10 and 12 years old for girl and boys respectively. This was to ensure that all the selected patients had at least four years of remaining growth before they reached skeletal maturity, which was expected at 14 years old for a girl and 16 years old for a boy 8 . Other studies were assessing majority of their patients within two to three years of follow-up rather than after skeletal maturity [5][6][7]9,10 .…”