Treatment for leg length discrepancy will depend on its cause, severity and the child’s age. In many cases, minor differences in leg length can be corrected by wearing a lift or insert in one shoe.
For more significant discrepancies, surgery may be recommended in order to obviate the complications highlighted above. Surgery procedures such as:
Epiphysiodesis
This procedure may be recommended for children who are still growing, to slow or stop the rate of growth in the longer leg, allowing the shorter limb to catch up in length. It is performed through small incisions around the knee and timed so that the leg lengths are equal by the time the child’s growth ends in their mid-to-late teens.
Limb Shortening
This is an option in cases with smaller discrepancies. This is done by removing a segment of bone from the middle of the longer limb. A metal plate or rod is inserted to hold the bones in place while it heals.
Limb Lengthening
This procedure is usually reserved for patients with significant discrepancies and may be performed externally or internally. Both types require regular follow-up visits to the doctor to monitor treatment progress, followed by extensive rehabilitation that includes physiotherapy.
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External lengthening
External lengthening involves cutting the bone in the shorter leg and inserting a frame, also known as an external circular-ring fixator, that is connected to the bone with pins or wires. The frame is manually turned to gradually pull the bones apart, allowing new bone to grow.
The frame is worn until the newly-grown bone is strong enough to support the patient. During this time, careful maintenance and cleaning of the pins are important to prevent infection.
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Internal lengthening
Internal lengthening similarly involves cutting the bone in the shorter leg. An expandable metal rod is surgically implanted and gradually lengthened, pulling the bones apart and allowing new bone to grow in its place. The process may take months, but the advantage is that it has less potential for wound complications.