Limb equalisation is mostly applied to the lower limb and is achieved by surgery rather than by manipulation of metabolic or endocrine parameters. The correction of upper limb discrepancy is performed at some specialist centres but generally both the complexity of the upper limb, and it's remarkable tolerance to limb discrepancy make this an unusual operation.
Limb discrepancy may be congenital or may be acquired as a result of fracture malunion, epiphyseal injury, infection or paralysis.
A general rule for the leg is that inequality greater than 2.5 cm requires treatment. Methods centre on controlled distraction of the epiphyseal plate - chondrodiatasis - or through a healing osteotomy - callotasis. Either the shorter leg may be lengthened, or the longer leg shortened, or both.
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