Leg Length Discrepancies in Nigerian Children with Sickle Cell Anaemia

Abstract

Background: Sickle cell anaemia, (SCA) the homozygous and most severe of the sickle cell diseases exerts adverse effects on growth and linear body proportions. In Nigeria, these changes in the lower extremity are scarcely documented. Objectives: To evaluate the differences between the real leg lengths and apparent leg lengths determined by tape measure among children with SCA. Methods: A clinic-based, cross-sectional, comparative study of 140 age and sex matched “SS” and “AA” children. The real leg lengths, anterior superior iliac spine to medial malleolus and to the heel, the apparent leg length, umbilicus to the medial malleolus were measured with a plastic tape and recorded.  Leg length discrepancy (LLD), the arithmetric differences between corresponding leg lengths were recorded and classified into nil (0), mild (<2cm), moderate (2-5cm) and severe (>5cm). Results: At the medial malleolus, the subjects had more mild and moderate Real LLD than controls while more controls than subjects had nil Real LLD (p = .033). Both right and left real leg lengths were significantly shorter in the 6-9 year old subjects especially the males, all female subjects, all 10-13 year olds subjects more so the females than their respective counterparts. (All p values < 0.05) Similarly, the right and left leg lengths at the heel were significantly shorter in subjects of the same age and sex groups as above than all their respective counterparts. (P values < 0.05). However, male subjects had only the right real leg length significantly shorter than those of the controls. Real LLD: ASIS-MM was significantly higher in 10-13 year old female subjects, real LLD: ASIS-HEEL in 14-18 year old subjects than the controls. The right and left apparent leg length were significantly lower in all 10-13 year old subjects as well as 10-13 year old female subjects than the respective matches. All p values were < 0.05. No significant difference existed in the apparent LLD comparisons.