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Limb length discrepancy care

Limb length discrepancy care

At Shriners Hospitals for Children — Salt Lake City, our specialists have a wealth of knowledge and experience treating children with limb length discrepancies, and through individualized care plans will help your child achieve the best results.

Limb length discrepancies are quite common. In fact, most people have one leg that is a little bit longer than the other or one foot that may be slightly larger than the other, generally with no ill effects. For children with significant limb length discrepancies, the difference between limbs can be debilitating.

At Shriners Hospitals for Children — Salt Lake City, our limb length discrepancy specialists are skilled at helping children with all types of limb length discrepancies and discussing all treatment and therapy options.

Congenital discrepancy – In congenital discrepancies, children are born with one leg longer than the other. Typically, these differences remain proportional. For example, a 10 percent difference will remain 10 percent, but the overall discrepancy increases in size as children grow. In some cases, both legs are normal except for the fact that one is shorter than the other. In other cases, one particular part of the leg is underdeveloped or absent.  

Acquired discrepancy – This is when children have no discrepancy at birth but something happens to damage their growth plate, such as a severe fracture or infection. The bone growth in that limb slows and results in a leg length discrepancy that increases as long as the child continues to grow. 

Functional discrepancy – The anatomic difference is minimal, but the external appearance and gait pattern indicate significant leg length discrepancy. Functional leg length discrepancies can be due to joint contractures, muscle weakness, scoliosis, and a variety of other causes.

Diagnosing limb length discrepancy

Some children may have no outward symptoms of a limb length discrepancy and symptoms can vary widely depending on other related conditions. Here are some common symptoms:

  • One leg is obviously shorter than the other.
  • Walking difficulties, such as limping, walking on the toes, rotation of the leg or a knee that seems to be hyperextended on one side and flexed on the other.
  • Pain in the back, hip, knee and/or ankle. Generally, children do not have pain from a leg length discrepancy until they reach near adult size.

Some limb length discrepancies are so small that they cannot be readily seen through physical examination. Others are easily identifiable but may require further testing to determine if there are other problems. Following a medical history and a physical examination that includes measuring the child’s legs, our orthopaedic specialist may want to conduct a variety of tests.

Evaluation and treatment of limb length discrepancies

The Salt Lake City Shriners Hospital is uniquely equipped to care for children with limb length differences, with its experienced medical staff, the variety of treatments available, and dedicated therapy services as an integral part of treatment and rehabilitation. The limb length discrepancy team works to determine the best course of treatment based on the severity of the discrepancy, other existing medical conditions, and the overall health and developmental status of the child.

Treatments available include:

  • Epiphysiodesis
  • Femoral shortening
  • Leg lengthening
  • Shoe lifts
  • Orthotics
  • Amputation/prosthetics

Our specialists

Philip McClure, M.D.
Jennifer Janowitz, D.P.T.

Please call 800-314-4283 to schedule an appointment.