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THR: Measure Leg Lengths

- Discussion:
- easiest method to measure leg lengths is the measure the distance from the ASIS and a marked point on the knee;
- measurement is made using the cautery cord;
- the thigh must be in the exact same position each time the length is measured;
- steinman pin method:
- separate posterior border of medius muscle from adjacent piriformis tendon by blunt dissection;
- bluntly dissect interval between minimus & superior capsule;
- insert Steinmann pin (under the minimus) into ilium superior to acetabulum & mark greater troch;
- note that if this pin is placed too posteriorly and too distally, then it will be difficult to broach the femur (and there will be a tendency to place the stem in varus);
- to remedy this situation, some surgeon place the pin directly thru the medius at a point more anteriorly and superiorly, so that it will not interfere with broaching;
- drill is inserted in greater trochanter;
- position of leg is marked (for subsequent remeasurement);
- measure distance between these two points to determine limb length after trial componenets are inserted

Compensating for changes in muscle length in total hip arthroplasty. Effects on the moment generating capacity of the muscles.



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