Does leg length discrepancy predict which foot will ulcerate in a patient with diabetes mellitus?

Abstract

Leg length discrepancy (LLD) affects about 60% to 95% of the general population and can result in functional complaints due to dynamic changes in musculoskeletal biomechanics. However, many people who have about 1 to 2.5 centimeters (cm) of LLD do not seem to have any clinical symptoms. Therefore, controversy still remains as to at what level of LLD intervention should be instituted. Yet, in a disease like diabetes mellitus, where the foot may be neuropathic and/or affected by some form of peripheral vascular disease, any amount of lower extremity discrepancy must be a cause for concern to any practitioner managing a diabetic foot. This article will review LLD and its biomechanical influence on the foot and how it may lead to plantar ulceration.