Leg length discrepancy or having one leg longer than the other is a quite common phenomenon in the pediatric and adult population. The standard discrepancy is commonly not more than 1.1 cm and it is negligible for patients but sometimes it can bring several ankle and leg problems.
If a child has leg length discrepancy, the parents usually notice it. Here is a guide to the symptoms, reasons and treatments of leg discrepancy.
The symptoms regarding leg length discrepancy differ from people to people. Children show varying symptoms than adults. Following are some common symptoms experienced by the people who face leg length discrepancy
- Issues with posture
- unequal legs
- Gait problems
- Walking problems like toe-walking
- A knee that’s chronically hyperextended
- Hip or back pain
- Increased tiredness
Patients who have varying 3-4 percent of total leg length that is about 4cm or 1-3 inches in an average adult may limp or have other issues while walking. Some research shows that patients having this issue are more likely to have low back pain and are more prone to injury. However, other studies do not support this information.
Causes of One Leg Longer Than The Other
The healing of a bone in a shortened position after a bone injury can lead to unequal legs. The chances increase if the bone breaks into several pieces. Severe damage to the tissue and skin around the bone also increase the probability of leg length discrepancy
When children go through bone fracture, their bones sometimes grow faster than normal, making it grow longer than the adjacent leg. This sort of overgrowth is common in children with bone injuries and is one of the reasons for having this.
Bone infections in infancy can cause leg length discrepancy. Following are some mentioned diseases that can lead to this:
- Neurofibromatosis – a genetic neurological disorder that can affect the brain, spinal cords and skin.
- Multiple hereditary exostoses – a genetic condition often passed down to children
- Ollier disease – a disease that is based on the noncancerous growth of the cartilages
- Osteomyelitis – an infection in bone
There are a few other causes of leg length discrepancy such as
- Neurologic conditions
- Phenomena that cause the inflammation of joints during growth.
In few of the cases of leg length discrepancy, the cause is unknown. Underdevelopment of the inner or outer side of the leg, or partial overgrowth may lead to one leg longer than the other too.
Occurrences like this are usually present at the time of birth but the difference is too small to be noticed. In these cases the leg length discrepancy can only be observed in the later years of the toddler. In underdevelopment, the bones become abnormally short.
It is vital to have a proper diagnosis of your child’s issue. They will have a proper assessment and treat your child accordingly. The treatments are broadly based on
- The child’s age
- The reasons of the discrepancy
- The size/magnitude of the discrepancy
The treatments to one leg longer than the other include the following treatments.
Medical treatment for One Leg Longer Than The Other
Minor leg length discrepancies are not serious and can be treated without any surgery. The surgery can lead to other side effects so non surgical treatments are usually preferred.
Most of the times when your child hasn’t matured completely regarding the skeletal system, the doctor may recommend just observing the toddler until the growth is complete. Regular reevaluations are vital in determining the consistency or increase of the discrepancy.
Most of the time a shoe lift is recommended by the doctors. It improves the ability of the patient to walk or run. Shoe lifts can also relieve back pain. This is a reliable and inexpensive treatment if your child is facing it.
If the discrepancy is severe, then a surgery may be necessary. The surgery is usually performed to:
- Slow down the growth of longer part
- Shorten the longer part
- Lengthen the shorter part
Following are some procedures performed in surgery to treat leg length discrepancy.
This procedure can be done in children who are still growing, to slow down the overgrowth of the bone. In this procedure:
- Destroying the growth plate or scraping it to stop further growth. This helps the shorter leg to catch up as the overgrown leg gradually decreases growing.
- Placing metal staples or screws around the sides of the growth plate to stop its growth.
This procedure is performed in the knee area with x-rays for guidance. The risks of this procedure include the possibility of over or under correction of the leg, the probability of shorter height of the adult or the disproportionate look of the patient’s body because of the shorter leg.
In this procedure, the doctor removes a section of bone from the longer limb and inserts a metal plate to hold the bone until it heals. Limbs can be shorten by limb shortening, however, it may weaken the muscles.
It is useful in patients with severe discrepancies in the length. This procedure includes cutting the bone in the shorter one into two parts and then surgically applying an external fixator.
In this method, an expendable rod is placed in the limb. The length of the rod increases gradually that stretches the limb and increases it.
Final word on One Leg Longer Than The Other
Now that you know the reasons and treatments of unequal legs it is vital that you get your child assessed to a doctor as soon as possible so that your child receives the appropriate treatment without any delays. Together you can help your child recover and get rid of any issue that they are facing.