Open Access Review

Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance

Gary A Knutson

Author Affiliations

840 W. 17th, Suite 5 Bloomington, IN, 47404, USA

Chiropractic & Osteopathy 2005, 13:11 doi:10.1186/1746-1340-13-11

Published: 20 July 2005

Abstract

Background

Leg-length inequality is most often divided into two groups: anatomic and functional. Part I of this review analyses data collected on anatomic leg-length inequality relative to prevalence, magnitude, effects and clinical significance. Part II examines the functional "short leg" including anatomic-functional relationships, and provides an outline for clinical decision-making.

Methods

Online database – Medline, CINAHL and MANTIS – and library searches for the time frame of 1970–2005 were done using the term "leg-length inequality".

Results and Discussion

Using data on leg-length inequality obtained by accurate and reliable x-ray methods, the prevalence of anatomic inequality was found to be 90%, the mean magnitude of anatomic inequality was 5.2 mm (SD 4.1). The evidence suggests that, for most people, anatomic leg-length inequality does not appear to be clinically significant until the magnitude reaches ~ 20 mm (~3/4").

Conclusion

Anatomic leg-length inequality is near universal, but the average magnitude is small and not likely to be clinically significant.

Keywords:
Leg-length inequality; anatomic; back pain; chiropractic