Limb Lengthening Discrepancy
You may be surprised to learn that most people have one leg that's just a bit longer than the other, or one foot that may be slightly larger. But for children with significant limb length discrepancies, the size difference between limbs can be a serious problem.
There are two types of
limb length discrepancies.
Congenital discrepancy is when babies are born with one leg longer than the other. In some cases both legs are normal, except that one is shorter than the other. In other cases one particular part of the leg is underdeveloped or is absent.
Acquired discrepancy is when babies are normal at birth, but some kind of injury happens, such as a severe fracture. The bone growth in that limb slows, which results in a leg length discrepancy that worsens as the child continues to grow.
Treatments for
limb length discrepancies include several options:
For minor limb length discrepancies (less than 2 cm), the answer could be a shoe lift, which is placed inside the child's shoe.
Epiphysiodesis (or disruption of the growth plate) slows/stops the growth of one or more of the growth plates of the leg. This allows the short leg to catch up and reach equality at maturity. It is the most simple and least risky of all treatments, but requires precise timing. If this procedure is performed at too early or too late an age, a leg length discrepancy may remain.
In adults, the growth plates are already closed, so epiphysiodesis is not an option. A segment of bone may be surgically removed. This is most often done in the femur (thigh bone).
Femoral shortening is when a part of the femur is surgically removed and internal fixation is used to stabilize the femoral segments.
For patients who do not want to undergo shortening, limb lengthening is an option.
In a limb lengthening procedure, the bone is cut and then lengthened slowly by means of an external or internal device. Most cases of
congenital limb length discrepancies can be treated with lengthening and reconstruction.
The bone will be lengthening at the rate of 1mm a day. If you have a 2 cm limb length discrepancy, that means the lengthening period is about 20 days. It usually takes any bone to completely heal in 6-8 weeks.
Bones lengthen easier than soft tissues, such as tendons, nerves and blood vessels. Therefore an extensive physical therapy regimen is usually an important part of any limb lengthening procedure.
If you or someone you love is interested in limb lengthening surgery, one of our skilled surgeons can examine your legs and give you the best course of action.