Leg length discrepancy (LLD) or Lower limb discrepancy is a condition of unequal lengths of the lower limbs. The discrepancy may be in the femur, or tibia, or both. In some conditions, the whole side is affected, including the upper limbs. However, it is the discrepancy of the lower limbs that causes problems with ambulation, and the focus of this discussion will be about lower limb discrepancy.
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.
The most common symptom of all forms of LLD is chronic backache. In structural LLD the sufferer may also experience arthritis within the knee and hip are, flank pain, plantar fasciitis and metatarsalgia all on the side that is longer. Functional LLD sufferers will see similar conditions on the shorter side.
Limb length discrepancy can be measured by a physician during a physical examination and through X-rays. Usually, the physician measures the level of the hips when the child is standing barefoot. A series of measured wooden blocks may be placed under the short leg until the hips are level. If the physician believes a more precise measurement is needed, he or she may use X-rays. In growing children, a physician may repeat the physical examination and X-rays every six months to a year to see if the limb length discrepancy has increased or remained unchanged. A limb length discrepancy may be detected on a screening examination for curvature of the spine (scoliosis). But limb length discrepancy does not cause scoliosis.
Non Surgical Treatment
You may be prescribed a heel lift, which will equal out your leg length and decrease stress on your low back and legs. If it?s your pelvis causing the leg length discrepancy, then your physical therapist could use your muscles to realign your pelvis and then strengthen your core/abdominal region to minimize the risk of such malalignment happening again. If you think that one leg may be longer than the other and it is causing you to have pain or you are just curious, then make an appointment with a physical therapist.
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For discrepancies over five centimeters, more aggressive surgical procedures-specifically leg lengthening procedures-are typically required. The specifics of this operative procedure are beyond the scope of this informational page, but your child's physician will be able to discuss the details in reference to your child's specific problems when considered appropriate.