Leg length discrepancy

People with leg length discrepancy have one leg longer than the other. This is because the thighbone (femur) or the calf bones (tibia and fibula), or both, are shorter in one leg. This could also be due to hip dysplasia.

Symptoms

The symptoms of leg length discrepancy depend on the cause and how much shorter one leg is. When the difference is small, it may not be noticeable at all. A larger difference can lead to limping, pain, or arthritis at an early age.

Depending on the patient's age and the cause of the "dysmetria" , it may remain the same or worsen as the person grows.

Causes

Leg length discrepancies are usually present from birth (called congenital ) and may not be noticeable until the individual grows older. They can also appear with age (called acquired ).

The causes of “congenital leg length discrepancy” are:

  • Peroneal hemimelia (Baby is born with a shorter or no calf bone)
  • Focal femoral deficiency (Baby is born with a short or missing thigh bone)
  • Hemihypertrophy (One side of the body grows more than the other)

The causes of “acquired leg length discrepancy” are:

  • fracture of a leg bone
  • bone infection.

Diagnosis

The diagnosis of leg length discrepancy should be the result of a professional and thorough examination of the patient's bones and muscles by a qualified physician. The protocol should be as follows:

  • talk with the family and the patient (if old enough)
  • perform a physical exam
  • measure both legs
  • observe how the patient walks
  • take X-rays or other diagnostic tests.

Treatment

In the treatment of leg length discrepancy, when the difference in leg length is slight, the problem is resolved with a shoe lift (elevating the shoe). This is all some people need. But if the leg length difference exceeds one inch (2.5 cm) or worsens as the child grows, surgery may be necessary.

For children who are still growing, epiphysiodesis may be performed. This is a relatively simple outpatient surgery in which the growth plates of the longer leg are scraped or compressed with a plate and screws. The growth plate is the part at the end of the bone where growth occurs. The purpose of the surgery is to slow the growth of the longer leg so that the shorter leg reaches the same length.

Sometimes, if a child has stopped growing, the doctor may correct the leg length discrepancy by shortening the longer leg. This involves removing a piece of bone from the longer leg.

Leg lengthening surgery for the shorter leg may also be considered. This surgery requires hospitalization and several weeks or months of aftercare and rehabilitation.

Tips for parents.

Improving leg length discrepancy can take many years. Parents and the medical and orthopedic team play a very important role in treatment.

These are the things that should be done:

  • Communicate with your child's care team about the treatment, duration, and care. Ask questions. Find out what each procedure is for and how to care for your child in the post.
  • Attend all scheduled medical appointments with your child.
  • If the patient is old enough, talk to them about the procedures and what to expect. If possible, involve older children in decision-making.

The choice of footwear plays a relevant role in the quality of life of the patient with “leg length discrepancy” , the best decision is to provide him/her with a “ THERAPEUTIC AND BIOMECHANICAL BOCCIO FOOTWEAR ” made to measure and adjusted to the particular needs of your child.

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