Leg Length Inequality
What is Leg Length Inequality？
● Leg length discrepancy (LLD) refers to a condition where one leg is shorter than the other. This can be a minor difference or a significant one, impacting a person's gait and overall biomechanics.
What are the possible causes of Leg Length Inequality?
● Skeletal disorders or dysplasias, including Ollier's disease (multiple chondrosarcomas), neurofibromatosis, and multiple hereditary osteochondromas.
● Skeletal infections that cause growth plate disorders.
● Neurological disorders such as cerebral palsy, spasticity and paralysis.
● Diseases that cause inflammation of the joints, such as juvenile idiopathic arthritis.
● Trauma or injury to the bone that may cause the bone to heal in a shorter position or grow faster than the unaffected side. Compound fractures (epiphyseal disruption) that occur near or within the growth plate are more likely to do this.
● Congenital conditions such as clubfoot, hip dysplasia, hemihypoplasia, and focal defects of the proximal femur, which can affect growth on one side of the body or in a specific bone, or result in an ‘artefactual’ difference.
● Tumours - or surgery to remove them - can temporarily or permanently affect the growth of nearby body parts.
In many cases, these conditions are present at birth, but limb length discrepancies may not become apparent until later in childhood.
Signs and symptoms of Leg Length Inequality
Leg length inconsistency, but when a child's legs are affected, the symptoms are more pronounced and treatment is usually required. The effects of inconsistent leg length vary from person to person, but symptoms may include:
● Uneven sizes of the femur (thigh bone) and tibia (shin bone) are most common, but the fibula (the smaller bone in the lower leg) may also be affected.
● Difficulty walking, including limping, hobbling or walking on the toes of the short leg. Easy fatigue due to the extra effort required to move.
● Inconsistent limb length also increases the risk of other related conditions, including low back pain, osteoarthritis and scoliosis.
Treatment of Leg Length Inequality？
Nonsurgical treatment
Patients who have a slight difference in leg length (less than an inch) and do not have any limb deformities can often be helped by non-surgical treatments. Treatment may include:
● Orthotics such as shoe inserts can be fitted to the inside or outside of the shoe. Insoles can relieve back pain caused by calf length discrepancies and are easily removed if they are not effective.
● Continuous observation (every 6 to 12 months) may be the best option for children with immature bones. Regular measurements can determine if the leg length difference is increasing or staying the same.
Surgical treatment
Surgical treatment for leg-length discrepancies is designed to:
● Slow down or stop the growth of the longer limb
● Lengthen the shorter limb
● Shorten the longer limb
Orthotic Insoles Improve Gait Symmetry and Reduce Immediate Pain in Subjects With Mild Leg Length Discrepancy