Leg Length Discrepancy

Leg Length Discrepancy

A number of causes may lead to leg length discrepancy inchildren. Differences in leg length frequently follow fracturesin the lower extremities in children due to over or understimulation of the growth plates in the broken leg. Leg lengthdiscrepancy may also be caused by a congenital abnormalityassociated with a condition called hemihypertrophy. Or it mayresult from neuromuscular diseases such as polio and cerebralpalsy. Many times, no cause can be identified. A small leg lengthdiscrepancy of a quarter of an inch or less is quite common inthe general population and of no clinical significance. Largerleg length discrepancies become more significant. The long-termconsequences of a short leg may include knee pain, back pain, andabnormal gait or limp.

The evaluation of leg length discrepancy typically involvessequential x-rays to measure the exact discrepancy, whilefollowing its progression. In addition, an x-ray of the wristallows us to more carefully age your child. Skeletal age andchronological age do not necessarily equal each other andfrequently a child's bone age will be significantly differentthan his or her stated age.

Your child's physician can establish a treatment plan once allthe facts are known: the bone age, the exact amount ofdiscrepancy, and the cause, if it can be identified.

Whether or not treatment should be pursued depends on the amountof discrepancy. In general, no treatment (other than a heel life,if desired) should be considered for discrepancies under twocentimeters. If the discrepancy measures between two and fivecentimeters, one might consider a procedure to equalize leglength. Usually, this would involve closure of the growth plateon the long side, thereby allowing the short side to catch up;shortening the long leg; or possibly lengthening the short leg.For discrepancies over five centimeters, more aggressive surgicalprocedures-specifically leg lengthening procedures-are typicallyrequired. The specifics of this operative procedure are beyondthe scope of this informational page, but your child's physicianwill be able to discuss the details in reference to your child'sspecific problems when considered appropriate.

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