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Understanding Skeletal Growth and Predicting Limb-Length Inequality in Pediatric Patients

Hubbard, Elizabeth W., MD; Liu, Raymond W., MD; Iobst, Christopher A., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: May 1, 2019 - Volume 27 - Issue 9 - p 312–319
doi: 10.5435/JAAOS-D-18-00143
Review Article

Limb-length inequality in a child can be a complex condition for patients, parents, and medical providers. Managing these patients and explaining the treatment options to families requires knowledge of the potential risks associated with leaving a discrepancy untreated and a thorough understanding of skeletal growth. The provider must also be familiar with the available growth prediction methods as treatment is influenced by the anticipated discrepancy at skeletal maturity. This article provides an overview to skeletal growth, assessing skeletal maturity and growth prediction to help providers develop an organized and thoughtful approach to treating pediatric patients with limb-length inequalities.

From the Department of Orthopaedic Surgery, Duke University Medical Center, Lenox Baker Children's Hospital, Durham, NC (Dr. Hubbard), the Department of Orthopaedic Surgery, Rainbow Babies & Children's Hospital, UH Hospitals, Cleveland, OH (Dr. Liu), and the Department of Orthopaedic Surgery, Nationwide Children's Hospital, Columbus, OH (Dr. Iobst).

Dr. Liu receives financial support from OrthoPediatrics for research and serves as a board member, owner, officer, or committee member of the Limb Lengthening and Reconstruction Society and the Pediatric Orthopaedic Society of North America. Dr. Iobst serves as a paid consultant to Nuvasive, Orthofix, Inc, and is a paid presenter or speaker for Smith & Nephew. Neither Dr. Hubbard nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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