Progress in Orthopaedic Surgery Vol. 1 Editorial Board N. Gschwend, Zurich D. Hohmann, Erlangen. J. L. Hughes, Jackson' D. S. Hungerford, Baltimore' G. D. MacEwen, Wilmington. E. Morscher, Basel. J. Schatzker, Toronto H. Wagner, Nuremberg/Altdorf. U. H. Weil, New Haven
Leg Length Discrepancy The Injured Knee Edited by David S. Hungerford Contributors W. Bandi, Interlaken J. Eichler, Wiesbaden. G. Figner, Basel P. Heidensohn, Erlangen. E. Hogue, Jackson. D. Hohmann, Erlangen J. L. Hughes, Jackson Ch. Kieser, Zurich E. Meyer, Hanover E. Morscher, Basel W. Miiller, Basel D. Petersen, Hanover. A. Riittimann, Zurich. H. Wagner, Nuremberg/Altdorf. M. Weigert, Erlangen With 100 Figures Springer-Verlag Berlin Heidelberg N ew York 1977
Editor: David S. Hungerford, The Johns Hopkins University, School of Medicine, The Good Samaritan Hospital, 5601 Loch Raven Boulevard, Baltimore, Maryland 21239, USA. ISBN-13: 978-3-642-66551-6 e-isbn-13: 978-3-642-66549-3 DOl: 10.1007/978-3-642-66549-3 Library of Congress Cataloging in Publication Data. Leg length discrepancy. (Progress in orthopaedic surgery; v. 1) Consists chiefly of articles from Der Orthopade, v. 1, 1972, and v. 3,1974. Bibliography: p. Includes index. L Leg length inequality-addresses, essays, lectures. 2. Knee Wounds and injuries-addresses, essays, lectures. I. Hungerford, David S. II. Bandi, W. III. Series. [DNLM: L Leg length inequality. 2. Knee injuries. WI PR677B v. 11WE850 L496] RD779.3.L43 617'.398 76-57743 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machine or similar means, and storage in data banks. Under 54 of the German Copyright Law where copies are made for other than private use, a fee is payable to the publisher, the amount of the fee to be determined by agreement with the publisher. by Springer-Verlag Berlin Heidelberg 1977 Softcover reprint of the hardcover 1st edition 1977 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Foreword by H. Wagner Research worldwide in the field of orthopaedic surgery has resulted in such an abundance of scientific and technical knowledge that textbooks no longer can keep abreast of new developments while journals, on the other hand, fail to provide a comprehensive broad view. To satisfy the orthopaedic surgeon's need for information, the Germanlanguage journal Der Orthopiide was founded in 1972. Since then, the journal has published the latest results of scientific research applicable to practice, and provided review papers which have also been of interest to those in allied specialities. This form of disseminating scientific knowledge has met with acceptance and found a wide circle of readers stretching beyond the boundaries of Europe. Many other orthopaedic surgeons have expressed an interest in the information contained in this publication but have found the language barrier insurmountable. A new series Progress in Orthopaedic Surgery has been created in order to make this information available. It will present both the.work of European authors in English and also original papers from American orthopaedic surgeons. Each volume will provide a broad overview of the current state of knowledge in one or two themes of orthopaedic surgery. The choice of themes will be decided by the editors with major emphasis on diagnosis, prevention, and treatment of orthopaedic disorders. The editors will call upon authorities in the field to supply these current reports. It is the editors' wish that this new series will build bridges across language barriers and enrich the exchange of information in orthopaedic surgery. Nuremberg/ Altdorf December 1976
Foreword by David S. Hungerford Two timely topics have been selected by the editors for the initial volume of the new series Progress in Orthopaedic Surgery. The series begins with primarily European contributions on a subject which is more prevalent in Europe than in many of the English speaking countries. It is therefore not surprising that significant advances have been achieved in the evaluation and treatment of significant leg length discrepan~y based on the need to solve the associated complex technical problems. This section on leg length discrepancy comprehensively covers the problem from diagnosis, methods of quantifying discrepancy, and pathomechanics to non-surgical and surgical treatment of the discrepancy. Recognized experts in the field have concisely presented their experience. Together these articles comprise a section which represents the "state of the art" for evaluation and treatment of leg length discrepancy. The second topic deals with the injured knee. Dr. Muller presents a comprehensive overview of the soccer player's knee. With the growing interest and involvement of this sport in the United States involving all age groups, this article will be particularly appreciated. Professors Bandi and Wagner deal with the question of cartilage injury in the knee. Certainly such lesions occur more frequently than they are diagnosed. Professor Bandi brings his long-standing interest and experience in patella pathology to bear on the question of a traumatic etiology of chondromalacia patellae. Professor Wagner elucidates a variety of kinds of cartilage injury, both direct and indirect, with practical suggestions for diagnosis and treatment. The first volume of Progress in Orthopaedic Surgery has been edited to introduce English-speaking orthopaedists to the works and thinking of their German-speaking colleagues. Outstanding work on timely topics has been selected with the hope that this series will provide a common ground for communication between these two important language groups. Baltimore December 1976
Contents Foreword by H. Wagner V Foreword by D. S. Hungerford VII Leg Length Discrepancy 1 J. L. Hughes, R. E. Hogue: Basic Rehabilitation Principles of Persons with Leg Length Discrepancy: An Overview 3 E. Morscher: Etiology and Pathophysiology of Leg Length Discrepancies 9 E. Morscher, G. Figner: Measurel1)ent of Leg Length 21 J. Eichler: Methodological Errors in Documenting Leg Length and Leg Length Discrepancies 29 E. Meyer, D. Petersen: Equalization of Leg Length with Orthopaedic Shoe Measures 41 P. Heidensohn, D. Hohmann, M. Weigert: Subtrochanteric Shortening and Lengthening Osteotomy 63 H. Wagner: Surgical Lengthening or Shortening of Femur and Tibia. Technique and Indications 71 The Injured Knee 9S A. Ruttimann, Ch. Kieser: The Importance of Arthrography Following Trauma to the Knee Joint 97 W. Muller: The KneeJ oint of the Soccer Player (Its Stresses and Damages) 117
x Contents W. Bandi: Trauma-Induced Chondromalacia Patellae 131 H. Wagner: Traumatic Injuries to the Articular Cartilage of the Knee 143 Subject Index 157 List of Contributors 159