Equalization of Leg Length with Orthopaedic Shoe Measures

Abstract

In the conservative management of patients with differences in leg length, two generally well-known methods are at our disposal. Where the difference in leg length is no greater than about 2.5 cm, this relatively slight imbalance can be easily corrected by simply elevating the heel or the heel and the sole. Where the difference is between 1.5 and 2.5 cm a better cosmetic result is obtained, provided the toe-piece is sufficiently high, by fitting a 0.5–1.0 cork instep into the shoe. The goal, even in slightly shortened legs, is full equalization and balance in order to avoid static stress on the spinal column. However, with differences of over 2.5 cm, the conversion of ready-made shoes in most cases no longer suffices. Here orthopaedic shoes must be prescribed in which the correction is built into the shoe and thus becomes a fixed part of the shoe (Fig. 1). This technique is well-known and will not be discussed in detail here. Its disadvantages are equally well-known, both with respect to function and the cosmetic aspect. Even though complete equalization is achieved, in the case of more marked length differences the shoe becomes increasingly clumsy, heavy, and unattractive. One often hesitates to carry out this albeit necessary procedure, preferring rather to put up with the abnormal strain on the spine and on the joints of the lower extremities.