📏 Chapter 717 · Leg-Length Discrepancy

Nelson Textbook of Pediatrics 22nd Edition | Etiologies: congenital (hemihypertrophy, PFFD, fibular/tibial hemimelia), acquired (physeal arrest, osteomyelitis, tumor), overgrowth syndromes (Beckwith-Wiedemann, PIK3CA). Evaluation: scanogram, CT, EOS. Treatment: shoe lift, epiphysiodesis (Menelaus, Moseley graph, multiplier method), limb lengthening (magnetic nail, Ilizarov), amputation for severe discrepancies (>20 cm).

🌐 paeds.online — Pediatric Learning Platform

📋 30 Clinical Scenarios — Leg-Length Discrepancy

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Leg-Length Discrepancy

Select a presentation to review diagnostic clues and management per Nelson Ch 717.

📋 Stepwise Management of Leg-Length Discrepancy

🔑 Key Principles — Nelson Chapter 717
• Goal: Discrepancy <2-2.5 cm at skeletal maturity.
• Evaluation: Clinical (block test, Galeazzi), scanogram/CT/EOS, bone age (Greulich-Pyle).
• Prediction methods: Menelaus (rule of thumb), Green-Anderson, Moseley straight-line graph, multiplier method.
• Treatment: Shoe lift (1 cm internal, 5 cm external). Epiphysiodesis (percutaneous) for 2-5 cm predicted discrepancy. Lengthening (magnetic nail, Ilizarov) for >5 cm. Amputation for >18-20 cm with foot deficiency.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Leg-Length Discrepancy (Nelson 717)