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charlotte2campos93

Leg Length Discrepancy Surgery Recovery

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Leg length discrepancy is the difference in lengths of an individual?s legs. This difference may be anatomical or may be due to scoliosis, trauma/injury, arthritis, overpronation (collapse) of one foot, bowing of one leg or unequal bowing, surgery (hip or knee replacement), pelvic tilting or ageing. The difference can also be functional caused by differing forces of the soft tissues, such as weakness in muscle tissue on one side, or a weakness/tightness in joint tissue. A difference in leg lengths also results when running on indoor banked tracks, beaches and banked streets and side walks (for drainage). Many people have a measurable difference in their leg lengths which is compensated for by their bodies. As we age this compensation does not work as well. An x-ray and physical measurements will define the discrepancy and the adjustment needed.Leg Length Discrepancy

Causes

Some limb-length differences are caused by actual anatomic differences from one side to the other (referred to as structural causes). The femur is longer (or shorter) or the cartilage between the femur and tibia is thicker (or thinner) on one side. There could be actual deformities in one femur or hip joint contributing to leg length differences from side to side. Even a small structural difference can amount to significant changes in the anatomy of the limb. A past history of leg fracture, developmental hip dysplasia, slipped capital femoral epiphysis (SCFE), short neck of the femur, or coxa vara can also lead to placement of the femoral head in the hip socket that is offset. The end-result can be a limb-length difference and early degenerative arthritis of the hip.

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

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

leg length discrepancy symptoms

Surgical Treatment

The type of surgery depends on the type of problem. Outpatient procedures may be used to alter the growth of the limb. This is often done through small incisions. If an outpatient procedure is done, your child can continue with most regular activities. Other times, surgery may be very involved and require the use of an external device that is attached to the limb with pins and wires. This device may be left on for months to correct the deformity or lengthen the leg. If this type of surgery is required, your child will be making weekly visits to Cincinnati Children's.

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