The Effect of Imposed Leg Length Difference on Pelvic Bone Symmetry

Cummings, Gordon S.; Scholz, John P.; Barnes, Kenneth P.

doi:10.1097/00007632-199303000-00012

Cited by 98 publications

(71 citation statements)

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“…3). This finding agrees with the results of other studies [19][20][21]. Pitkin and Pheasant [19] used a large lift (38 mm) and thereby induced relative anterior rotation of the innominate on the side opposite the lift as well as other effects on the pelvis and lumbar spine that they observed to be similar to a typical functional scoliosis.…”

Section: Pel6ic Torsionsupporting

confidence: 92%

“…Pitkin and Pheasant [19] used a large lift (38 mm) and thereby induced relative anterior rotation of the innominate on the side opposite the lift as well as other effects on the pelvis and lumbar spine that they observed to be similar to a typical functional scoliosis. Cummings et al [20] examined the effects of lifts ranging in height from 6 to 22 mm in subjects with leg length inequalities less than 4 mm and found relative anterior rotation of the contralateral innominate, to a degree proportional to the height of the lift. Beaudoin et al [21] used a 15-mm lift and likewise found relative anterior rotation of the contralateral innominate.…”

Section: Pel6ic Torsionmentioning

confidence: 99%

“…1), does not necessarily reflect lateral sacral tilt [17], in part because of accompanying pelvic torsion (Fig. 3) [19][20][21]. A clinician would thus be naïve to believe that a given difference in height between the iliac crests directly reflects a leg length inequality of the same magnitude.…”

Section: Iliac Crest Height 6ersus Leg Length Inequalitymentioning

confidence: 99%

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Effect of simulating leg length inequality on pelvic torsion and trunk mobility

2000

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Section: Pel6ic Torsionsupporting

confidence: 92%

Section: Pel6ic Torsionmentioning

confidence: 99%

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Effect of simulating leg length inequality on pelvic torsion and trunk mobility

2000

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“…LLD after THA has been associated with complications, including sciatic, femoral, and peroneal nerve palsies [32,34,46,50]; low back pain [1,9,13,14]; abnormal gait [17,26]; and dislocation [56].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Meermans

Malik

Witt

et al. 2011

Clinical Orthopaedics &Amp; Related Research

153

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Background Pelvic radiographs are helpful in assessing limb-length discrepancy (LLD) before and after THA but are subject to variation. Different methods are used to determine LLDs. As a pelvic reference, both ischial tuberosities and the teardrops are used, and as a femoral reference, the lesser trochanter and center of the femoral head are used. Questions/purposes We validated the different methods for preoperative radiographic measurement of LLDs and evaluated their reliability. Patients and Methods LLDs were measured on full-leg radiographs for 52 patients (29 men, 23 women) with osteoarthritis (OA) of the hip and compared with different methods for measuring LLDs on AP radiographs of the pelvis. Results The true LLD varied from À8.0 to 9.1 mm. When the biischial line was used as a pelvic reference, the LLD measured on AP pelvis radiographs was different from the true LLD. No difference was found when the interteardrop line was used as a pelvic reference. There was substantial interobserver agreement when the lesser trochanter was used as a femoral reference (kappa = 0.66-0.70) and excellent interobserver and intraobserver agreement for all other measurements (kappa = 0.84-0.93). Conclusions Our data show use of the biischial line as a pelvic reference should be discouraged and the interteardrop line is a better alternative. The center of the femoral head is a more reliable femoral landmark compared with the lesser trochanter. Level of Evidence Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…Giles found that there was always anterior rotation of the innominate bone on the side of a the short leg. Although Giles himself does not make the following point, Cummings et al 21 interpret these findings to mean that there must have been anterior rotation of the ilium and sacrum on the side of the shorter leg. This study, therefore, qualifies as a natural experiment in which the impact of naturally occurring anatomical LLI on pelvic torsion may be inferred.…”

Section: Naturally Occurring Llimentioning

confidence: 99%

The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature

Cooperstein

Lew

2009

Journal of Chiropractic Medicine

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Objective: Although it is common to find assertions relating functional leg length inequality (LLI) to pelvic torsion and other states of subluxation, comments and/or data concerning anatomical LLI in this same context are uncommon. This review of the literature synthesizes the evidence on pelvic torsion in relation to anatomical LLI. Methods: The literature was searched using the PubMed; Manual, Alternative, and Natural Therapy Index System; Allied and Complementary Medicine Database; Cumulative Index to Nursing and Allied Health Literature; and Index to Chiropractic Literature databases for primary studies that related LLI, either artificially created or naturally occurring, to pelvic torsion. Extracted data included natural vs artificial LLI, method of creating or detecting LLI, subject selection, methodology for measuring pelvic torsion, and results. Results: Nine English-language studies were retrieved published 1936-2004. Seven determined the impact of artificial, transient LLI on pelvic torsion, whereas 2 studied the effect of naturally occurring LLI. Conclusion: Across varying methodologies for measuring LLI and pelvic torsion, a consistent, dose-related pattern was identified in which the innominate rotates anteriorly on the side of a shorter leg and posteriorly on the side of the longer leg. This finding was contrary to the common assertion that the ilium rotates posteriorly on the side of a short leg and vice versa. Practitioners of manual medicine who derive vectors for intervention based on leg checking procedures should consider the possibility that the direction of pelvic torsion may be variable depending on whether the LLI is of anatomical or functional origin.

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The Effect of Imposed Leg Length Difference on Pelvic Bone Symmetry

Cited by 98 publications

References 0 publications

Effect of simulating leg length inequality on pelvic torsion and trunk mobility

Effect of simulating leg length inequality on pelvic torsion and trunk mobility

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

The relationship between pelvic torsion and anatomical leg length inequality: a review of the literature

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