Functional Leg Length Discrepancy Causes

Overview

Having one leg shorter than the other is a common physical condition. It has two primary causes--structural or functional problems. Structural differences in length can be the result of growth defect, previous injuries or surgeries. Functional differences in length can result from altered mechanics of the feet, knee, hip and/or pelvis. These altered mechanics from functional leg length discrepancy often stem from having an unbalanced foundation.Leg Length Discrepancy

Causes

Limb-length conditions can result from congenital disorders of the bones, muscles or joints, disuse or overuse of the bones, muscles or joints caused by illness or disease, diseases, such as bone cancer, Issues of the spine, shoulder or hip, traumatic injuries, such as severe fractures that damage growth plates.

Symptoms

The patient/athlete may present with an altered gait (such as limping) and/or scoliosis and/or low back pain. Lower extremity disorders are possibly associated with LLD, some of these are increased hip pain and degeneration (especially involving the long leg). Increased risk of: knee injury, ITB syndrome, pronation and plantar fascitis, asymmetrical strength in lower extremity. Increased disc or vertebral degeneration. Symptoms vary between patients, some patients may complain of just headaches.

Diagnosis

Limb length discrepancy can be measured by a physician during a physical examination and through X-rays. Usually, the physician measures the level of the hips when the child is standing barefoot. A series of measured wooden blocks may be placed under the short leg until the hips are level. If the physician believes a more precise measurement is needed, he or she may use X-rays. In growing children, a physician may repeat the physical examination and X-rays every six months to a year to see if the limb length discrepancy has increased or remained unchanged. A limb length discrepancy may be detected on a screening examination for curvature of the spine (scoliosis). But limb length discrepancy does not cause scoliosis.

Non Surgical Treatment

The most common solution to rectify the difference in your leg lengths is to compensate for the short fall in your shortest leg, thereby making both of your legs structurally the same length. Surgery is a drastic option and extremely rare, mainly because the results are not guaranteed aswell as the risks associated with surgery, not to mention the inconvenience of waiting until your broken bones are healed. Instead, orthopediatrician's will almost always advise on the use of "heel lifts for leg length discrepancy". These are a quick, simple and costs effective solution. They sit under your heel, inside your shoe and elevate your shorter leg by the same amount as the discrepancy. Most heel lifts are adjustable and come in a range of sizes. Such lifts can instantly correct a leg length discrepancy and prevent the cause of associate risks.

Leg Length Discrepancy Insoles

leg length discrepancy lifts

Surgical Treatment

Surgeries for LLD are designed to do one of three general things ? shorten the long leg, stop or slow the growth of the longer or more rapidly growing leg, or lengthen the short leg. Stopping the growth of the longer leg is the most commonly utilized of the three approaches and involves an operation known as an epiphysiodesis , in which the growth plate of either the lower femur or upper tibia is visualized in the operating room using fluoroscopy (a type of real-time radiographic imaging) and ablated , which involves drilling into the region several times, such that the tissue is no longer capable of bone growth. Because the epiphyseal growth capabilities cannot be restored following the surgery, proper timing is crucial. Usually the operation is planned for the last 2 to 3 years of growth and has excellent results, with children leaving the hospital within a few days with good mobility. However, it is only appropriate for LLD of under 5cm.
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