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Etymology and synonyms: The word "dysmetria" is formed with Greek roots and means "disorder when performing muscular movements caused by an inadequate appreciation of distance." Its lexical components are: the prefix dis- (bad, difficult), metron (measurement), plus the suffix -ia (quality).
Definition: Dysmetria is a disease in which the length between the bone segments of the lower limbs is different: it is a common disorder, suffered by 1 in 3 people. is the discrepancy in the length of the limbs. Extremity dysmetria is a frequent reason for consultation in children's orthopedics.
Symptoms and diagnosis: discrepancies in the lower extremities result in an alteration in gait, in addition to the aesthetic impact. In these patients, an irregular and unstable gait occurs, through tilting of the pelvis towards the side of the short limb, and deviation of the spine in the opposite direction. On the other hand, it is generally accepted that differences greater than 2.5 cm. In adulthood they can cause low back pain and a scoliotic attitude. The most common symptoms are:
• Alteration of gait and constant loss of balance.
• Discomfort when walking and very strong pain in the feet, ankles and knees.
• Scoliotic posture (deviated to one side). Dysmetria is easy to detect, the most used diagnostic tests are:
Ultrasound methods: It is recommended to perform the general examination with the patient in underwear, in order to assess skin aspects, the length of the upper limbs, among others. At an early age (especially the first year of life), examination of the hip is of vital importance for the assessment of dysplastic phenomena.
Osteopathic tests: These are mobility tests of the different anatomical parts, which are used to detect structures with reduced mobility and determine the appropriate technique for that specific dysfunction.
ETIOLOGY: CAUSES AND RISK FACTORS: The following causes can cause actual shortening of the lower extremities:
• Congenital growth deficiencies: Approximately 3 to 4% of babies born in the United States have congenital malformations that will affect their appearance, development, or function, including dysmetria.
• Bone or joint infections: Infections can reach a bone by traveling through the bloodstream or by spreading from nearby tissue. Infections can also start in the bone itself if an injury exposes the bone to germs, this can cause limb difference.
• Hip prostheses: Hip prostheses are designed to mimic the action of the ball and socket joint of the hip joint. During hip replacement surgery, the surgeon removes the diseased or damaged parts of the hip joint and inserts the artificial joint, which can cause failure in both limbs.
• Growth plate fractures or dysfunction: Growth plate fracture affects the layers of tissue near the ends of the child's bones. Growth plates are the softest and weakest sections of the skeleton. Sometimes, they are even weaker than the surrounding ligaments and tendons.
Treatment and therapies: Once the possible main cause of the dysmetria has been detected, it will be easy to identify the treatment to combat or reverse its evolution. Generally, the type of treatment is usually chosen based on the magnitude of the discrepancy.
• Dismetries less than 1 cm. They are usually well tolerated and only require periodic controls during growth stages.
• Differences between 1-3 cm. They are treated with special insoles or heel pads that increase height and can give full support to the affected limb and reduce pain.
• Dismetries greater than 3 cm. They are usually treated with surgical methods: Patients with a prognosis of dysmetria between 3 and 7 cm. They can be treated with epiphysiodesis, or with lengthening techniques, while those predicted to have a dysmetria greater than 7 cm. They are usually treated by lengthening, in one or more surgical procedures.
Conclusions: Some dysmetries may be from birth and with the passage of time these can adapt and not cause any problems, in other cases when an accident or fracture occurs and a sudden dysmetria occurs, it does cause pain much faster and therefore Therefore, we must seek to recognize the situation and its level to provide the appropriate solution.
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