Overview
Your child has been diagnosed with a leg-length discrepancy. This means that your child?s legs are slightly different lengths, with one leg longer than the other. The difference in lengths can vary widely. The larger the difference in lengths, the more problems that can result as the child gets older. Because of this, your child may be referred to a pediatric orthopedist (doctor specializing in treating bone and joint problems in children) for evaluation and possible treatment.
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 effects vary from patient to patient, depending on the cause of the discrepancy and the magnitude of the difference. Differences of 3 1/2 to 4 percent of the total length of the lower extremity (4 cm or 1 2/3 inches in an average adult), including the thigh, lower leg and foot, may cause noticeable abnormalities while walking and require more effort to walk. Differences between the lengths of the upper extremities cause few problems unless the difference is so great that it becomes difficult to hold objects or perform chores with both hands. You and your physician can decide what is right for you after discussing the causes, treatment options and risks and benefits of limb lengthening, including no treatment at all. Although an LLD may be detected on a screening examination for curvature of the spine (scoliosis), LLD does not cause scoliosis. There is controversy about the effect of LLD on the spine. Some studies indicate that people with an LLD have a greater incidence of low back pain and an increased susceptibility to injuries, but other studies refute this relationship.
Diagnosis
A systematic and well organized approach should be used in the diagnosis of LLD to ensure all relevant factors are considered and no clues are overlooked which could explain the difference. To determine the asymmetry a patient should be evaluated whilst standing and walking. During the process special care should be used to note the extent of pelvic shift from side to side and deviation along the plane of the front or leading leg as well as the traverse deviation of the back leg and abnormal curvature of the spine. Dynamic gait analysis should be conducted during waling where observation of movement on the sagittal, frontal and transverse planes should be noted. Also observe head, neck and shoulder movements for any tilting.
Non Surgical Treatment
A properly made foot orthotic can go a long way in substituting additional millimeters or centimeter on the deficient side. Additional full length inserts are added to the shorter side bringing the runner closer to symmetrical. Heel lifts do not work in runners because when you run you may land on your heel but the rest of the time you are on your forefoot then your toes pushing off. The right custom-made, biomechanical orthotic can address the underlying cause of your pain. Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized. San Diego Running Institute orthotics are custom molded to your foot and are designed with your specific body weight, leg length discrepancy, and activity in mind. The restoration of correct mechanical function takes the abnormal stress from the uneven side and allows the body to heal naturally.
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Surgical Treatment
Differences of an inch-and-a-half to two inches may require epiphysiodesis (adjusting the growth of the longer side) or acute shortening of the other side. Differences greater than 2.5 inches usually require a lengthening procedure. The short bone is cut and an external device is applied. Gradual lengthening is done over months to allow the muscles and nerves accommodate the new length.
Your child has been diagnosed with a leg-length discrepancy. This means that your child?s legs are slightly different lengths, with one leg longer than the other. The difference in lengths can vary widely. The larger the difference in lengths, the more problems that can result as the child gets older. Because of this, your child may be referred to a pediatric orthopedist (doctor specializing in treating bone and joint problems in children) for evaluation and possible treatment.
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 effects vary from patient to patient, depending on the cause of the discrepancy and the magnitude of the difference. Differences of 3 1/2 to 4 percent of the total length of the lower extremity (4 cm or 1 2/3 inches in an average adult), including the thigh, lower leg and foot, may cause noticeable abnormalities while walking and require more effort to walk. Differences between the lengths of the upper extremities cause few problems unless the difference is so great that it becomes difficult to hold objects or perform chores with both hands. You and your physician can decide what is right for you after discussing the causes, treatment options and risks and benefits of limb lengthening, including no treatment at all. Although an LLD may be detected on a screening examination for curvature of the spine (scoliosis), LLD does not cause scoliosis. There is controversy about the effect of LLD on the spine. Some studies indicate that people with an LLD have a greater incidence of low back pain and an increased susceptibility to injuries, but other studies refute this relationship.
Diagnosis
A systematic and well organized approach should be used in the diagnosis of LLD to ensure all relevant factors are considered and no clues are overlooked which could explain the difference. To determine the asymmetry a patient should be evaluated whilst standing and walking. During the process special care should be used to note the extent of pelvic shift from side to side and deviation along the plane of the front or leading leg as well as the traverse deviation of the back leg and abnormal curvature of the spine. Dynamic gait analysis should be conducted during waling where observation of movement on the sagittal, frontal and transverse planes should be noted. Also observe head, neck and shoulder movements for any tilting.
Non Surgical Treatment
A properly made foot orthotic can go a long way in substituting additional millimeters or centimeter on the deficient side. Additional full length inserts are added to the shorter side bringing the runner closer to symmetrical. Heel lifts do not work in runners because when you run you may land on your heel but the rest of the time you are on your forefoot then your toes pushing off. The right custom-made, biomechanical orthotic can address the underlying cause of your pain. Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized. San Diego Running Institute orthotics are custom molded to your foot and are designed with your specific body weight, leg length discrepancy, and activity in mind. The restoration of correct mechanical function takes the abnormal stress from the uneven side and allows the body to heal naturally.
how to grow taller at 16
Surgical Treatment
Differences of an inch-and-a-half to two inches may require epiphysiodesis (adjusting the growth of the longer side) or acute shortening of the other side. Differences greater than 2.5 inches usually require a lengthening procedure. The short bone is cut and an external device is applied. Gradual lengthening is done over months to allow the muscles and nerves accommodate the new length.