Leg Length Discrepancy Shoes

Overview


The field of leg length inequalities or leg length discrepancy often abbreviated as LLD is well documented and understood. There are two types of short legs; functional (functional LLD) and structural (true LLD). A functional short leg occurs as a result of muscle imbalances, pelvic torsion or other mechanical reasons. The millimeters of ?appearing? short are typically less than 10, and are do not appear on Xray. This article is about structural or anatomical short legs.Leg Length Discrepancy


Causes


A patient?s legs may be different lengths for a number of reasons, including a broken leg bone may heal in a shorter position, particularly if the injury was severe. In children, broken bones may grow faster for a few years after they heal, resulting in one longer leg. If the break was near the growth center, slower growth may ensue. Children, especially infants, who have a bone infection during a growth spurt may have a greater discrepancy. Inflammation of joints, such as juvenile arthritis during growth, may cause unequal leg length. Compensation for spinal or pelvic scoliosis. Bone diseases such as Ollier disease, neurofibromatosis, or multiple hereditary exostoses. Congenital differences.


Symptoms


LLD do not have any pain or discomfort directly associated with the difference of one leg over the other leg. However, LLD will place stress on joints throughout the skeletal structure of the body and create discomfort as a byproduct of the LLD. Just as it is normal for your feet to vary slightly in size, a mild difference in leg length is normal, too. A more pronounced LLD, however, can create abnormalities when walking or running and adversely affect healthy balance and posture. Symptoms include a slight limp. Walking can even become stressful, requiring more effort and energy. Sometimes knee pain, hip pain and lower back pain develop. Foot mechanics are also affected causing a variety of complications in the foot, not the least, over pronating, metatarsalgia, bunions, hammer toes, instep pain, posterior tibial tendonitis, and many more.


Diagnosis


The doctor carefully examines the child. He or she checks to be sure the legs are actually different lengths. This is because problems with the hip (such as a loose joint) or back (scoliosis) can make the child appear to have one shorter leg, even though the legs are the same length. An X-ray of the child?s legs is taken. During the X-ray, a long ruler is put in the image so an accurate measurement of each leg bone can be taken. If an underlying cause of the discrepancy is suspected, tests are done to rule it out.


Non Surgical Treatment


Whether or not treatment should be pursued depends on the amount of discrepancy. In general, no treatment (other than a heel life, if desired) should be considered for discrepancies under two centimeters. If the discrepancy measures between two and five centimeters, one might consider a procedure to equalize leg length. Usually, this would involve closure of the growth plate on the long side, thereby allowing the short side to catch up; shortening the long leg; or possibly lengthening the short leg.


LLL Shoe Insoles


Surgical Treatment


Surgical options in leg length discrepancy treatment include procedures to lengthen the shorter leg, or shorten the longer leg. Your child's physician will choose the safest and most effective method based on the aforementioned factors. No matter the surgical procedure performed, physical therapy will be required after surgery in order to stretch muscles and help support the flexibility of the surrounding joints. Surgical shortening is safer than surgical lengthening and has fewer complications. Surgical procedures to shorten one leg include removing part of a bone, called a bone resection. They can also include epiphysiodesis or epiphyseal stapling, where the growth plate in a bone is tethered or stapled. This slows the rate of growth in the surgical leg.

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Crystle Altwies

Author:Crystle Altwies
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