Limb Length discrepancy for First year Physiotherapy students.

1. DR.K RU PA SHA H
(M PT IN M U SCU LOSK ELET A L A ND SPORT S)
Leg Length Discrepancy

2. Definition
 LLD is a condition in which the paired lower
extremities have a noticeably unequal length.
 LLD also known as an Anosomelia.
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Leg Length Discrepency

3. 3
Leg Length Discrepency

4. TYPES OF SHORTENING
STRUCTURAL
(True)
Caused by
anatomical or
structural
changes
Spine and pelvis
often affected
may be congenital
or acquired
FUNCTIONAL
(Apparent)
Compensation or
occur due to
positioning
May occur
because of
scoliosis
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Leg Length Discrepency

5. CAUSES
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Leg Length Discrepency
Developm
ental
abnormali
ty
soft tissue
shortenin
g&contrac
ture
Degenerat
ive
disorder
Trauma
Fracture
CAUSES

6. PELVIC SQUARING
Leg Length Discrepency
6

7. CONT..
Leg Length Discrepency
7
 Leg should be 15-20cm (4-8 inches) apart and
parallel each other.
 Both ASIS should be in same line.

8. MEASUREMENT
Leg Length Discrepency
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Two types:
1. True shortening measurement
2. Apparent shortening measurement

9. True shortening measurement
Leg Length Discrepency
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 The measurement is taken from ASIS to the medial
or lateral malleolus of patient with inch tape.
 1 to 1.5 cm difference is normal.

10. Cont..
Leg Length Discrepency
10
If any abnormality can be seen
than to know the correct area of
LLD examiner has to measure:
From ASIS to
greatertrochanter(forcoxavara)
From greatertrochanterto lateral
knee joint line(for femoral
shortening)
From medial knee joint line to the
medialmalleolus(fortibialshortening)

11. Apparent shortening measurement
Leg Length Discrepency
11
 Even though true shortening measurement shows nil
result but examiner may feel the difference in leg
length in observation.
 That time Apparent leg length measurement can be
done.
 Difference might be due to spinal or pelvic problem.
 Measurement can be taken from umbilicus or xiphoid
sternum to medial malleolus.

12. Weber Barstow Maneuver
Leg Length Discrepency
12
It is a visual method to measure leg length asymmetry.
• Patient lies supine with hip & knee flexed.
• Examiner stands at patient’s feet and palpate the distal aspect of
medialmalleoliwith the thumb.
• Than patient lift the pelvis from examining table &return to the
starting position.
• Examiner passively extend the leg and compare the position
ofmalleoliusing border of thumb.’
• Different level indicate asymmetry.

13. Leg Length Discrepency
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14. TIBIAL LENGTH
Leg Length Discrepency
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Patient lying
prone.
Examiner
places the
thumbs
transversely
across the soles
of feet just in
front of heel.
Knees are
flexed 90◦
Relative heights
of thumbs are
noted.
Care must be
taken to ensure
that the legs are
perpendicular
to the
examining
table.

15. FEMORAL LENGTH
Leg Length Discrepency
15
Can be compared by
having the patient lie
supine.
Hips and knees
flexed 90◦.
If one femur is
longer than the other
, aits height will be
higher.

16. Leg Length Discrepency
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