In this article
Buchanan Orthotics undertake all types of footwear adaptations for both the NHS and individuals. Our Orthopaedic technicians based at our head office on Helen Street, Glasgow, have a wealth of experience in adapting both shop-bought and orthopaedic footwear.
A True shortening means that there is a physical bony shortening of the bones of the leg and can have a number of causes. .
Apparent leg length discrepancy occurs when the legs appear to be of different lengths, despite being physically the same length. The most common causes of apparent leg length discrepancy include:
When it comes to assessing leg length discrepancy, there are various methods to measure and determine the extent of the difference. While imaging techniques such as long-leg X-rays provide the most accurate measurements, they are only sometimes feasible or readily available in all cases. Physical assessment techniques are commonly employed in such situations to measure leg length discrepancy. Orthotists, in particular, utilise two primary methods for this purpose.
Both of these methods below are clinically valid in assessing leg length discrepancy. Orthotists often employ both techniques to ensure accuracy and cross-verify measurements. The choice of method depends on the individual patient and their specific condition.
In the block test, the orthotist will have the patient stand on blocks of different heights. The orthotist assesses if the patient's hips are level by carefully palpating bony landmarks on the pelvis.This is ususally the ASIS on the anterior side of PSIS posteriorly. This test aims to determine the height of the raise required to level the hips. This method is advantageous as it is conducted in a weight-bearing position, where leg shortenings are most noticeable. It also gives patients a sense of the raise height they may require.
Another commonly employed method involves using a tape measure to measure the distance between specific bony landmarks on the patient's hips and either ankle bones or the heel. The most commonly used landmarks are the ASIS to the apex of the medial malleolus. It can often be helpful to mark the position on the anke to allow multiple measures to be taken and an average calculated. Measurements are taken for each leg, and the difference between them determines the height of the raise. This method is straightforward and enables quantification of the leg length difference and shows a true leg length difference.
To measure an apparent shortening the proximal tape position is in the centre of the abdomen and does not move when measuring each leg.
At Buchanan Orthotics, we have a Footwear adaption department where we can add external and internal shoe raises to both shop footwear and orthopaedic footwear.
Yes, we can provide an assessment at our clinic in Glasgow and Edinburgh
We also have a further guide on our Clinic Website.