tibial length test
Patient Position
- Have the patient lie in the supine position with the hips flexed at a 45 degree angle and the knees flexed at a 90 degree angle. The patient's feet should lie flat on the surface of the table with each foot reaching the same point of the table.
Directions
- Observe the patient from the front looking for a discrepancy at the level of the top of the knees.
- Observe the patient from the lateral view looking for a discrepancy at the level of the top of the knees.
Expected Results
- The top of the knees should appear even when the patient is lying in this position. The even level of the knees should be evident in both views (front and lateral).
Positive Sign
- The level of the top of the knees appears to be uneven when the patient is placed in the noted position.
Implications
- A positive sign indicates the patient has a tibial length discrepancy.
- Have the patient lie in the supine position with the hips flexed at a 45 degree angle and the knees flexed at a 90 degree angle. The patient's feet should lie flat on the surface of the table with each foot reaching the same point of the table.
Directions
- Observe the patient from the front looking for a discrepancy at the level of the top of the knees.
- Observe the patient from the lateral view looking for a discrepancy at the level of the top of the knees.
Expected Results
- The top of the knees should appear even when the patient is lying in this position. The even level of the knees should be evident in both views (front and lateral).
Positive Sign
- The level of the top of the knees appears to be uneven when the patient is placed in the noted position.
Implications
- A positive sign indicates the patient has a tibial length discrepancy.
Treatment Options
- A tibial leg length discrepancy can be treated conservatively or surgically.
- Conservatively, this condition can be treated by using a heel lift in the shoe of the leg that has a shorter measurement. This treatment method has boundaries and it's effectiveness will depend on the margin of the discrepancy that is found. An individual using this treatment will likely need regular osteopathic manipulative treatment from a certified physician due to the effect this condition has on the hips.
- Surgically, this condition can be treated by either retarding the growth of the longer limb (in young patients who are still growing) or lengthening the tibia of the shorter leg (in adult patients).
- Tibial length discrepancies of 2.5 cm or less can usually be effectively treated with orthotic heel lifts and regular osteopathic manipulative treatments.
- Discrepancies that present larger than 2.5 cm may require surgical intervention and that decision should be made by a team of orthopedic surgeons that specialize in this area of surgery.
- A tibial leg length discrepancy can be treated conservatively or surgically.
- Conservatively, this condition can be treated by using a heel lift in the shoe of the leg that has a shorter measurement. This treatment method has boundaries and it's effectiveness will depend on the margin of the discrepancy that is found. An individual using this treatment will likely need regular osteopathic manipulative treatment from a certified physician due to the effect this condition has on the hips.
- Surgically, this condition can be treated by either retarding the growth of the longer limb (in young patients who are still growing) or lengthening the tibia of the shorter leg (in adult patients).
- Tibial length discrepancies of 2.5 cm or less can usually be effectively treated with orthotic heel lifts and regular osteopathic manipulative treatments.
- Discrepancies that present larger than 2.5 cm may require surgical intervention and that decision should be made by a team of orthopedic surgeons that specialize in this area of surgery.