Leg Length Discrepancy Barefoot Running
Overview
Surgeries to lengthen a leg are generally only performed when there is a difference in leg length of greater than four centimeters. These types of surgeries can be more difficult and have more complications, such as infections, delayed healing, dislocations, and high blood pressure. In a several step process, bone lengthening surgeries involve cutting a bone in two in order to allow new bone growth to occur. After the bone is cut, a special apparatus is worn with pins that will pull the bone apart at approximately one millimeter per day. This causes osteogenesis, or new bone growth, in between the cut bone segments. A cast or brace may be required for several months after surgery to allow the new bone growth to harden and provide extra support.
Causes
Common causes include bone infection, bone diseases, previous injuries, or broken bones. Other causes may include birth defects, arthritis where there is a loss of articular surface, or neurological conditions.
Symptoms
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.
Diagnosis
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
Treatment for an LLD depends on the amount of difference and the cause, if known. The doctor will discuss treatment options carefully with you and your child before any decisions are made. It is important to note that treatment is planned with the child?s final height and leg lengths in mind, not the current leg lengths. Treatment is generally not needed if the child?s final LLD is predicted to be 2 centimeters or less at full height. However, the child should return to an orthopaedic doctor by age 10 for re-evaluation. Treatment is often recommended for LLDs predicted to be more than 2 centimeters at full height. If treatment is done, it usually doesn?t begin until the child starts walking. Possible treatment options include, A ?lift? in one shoe to level the child?s hips. This is often the only treatment needed for small discrepancies.
Surgical Treatment
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.
Surgeries to lengthen a leg are generally only performed when there is a difference in leg length of greater than four centimeters. These types of surgeries can be more difficult and have more complications, such as infections, delayed healing, dislocations, and high blood pressure. In a several step process, bone lengthening surgeries involve cutting a bone in two in order to allow new bone growth to occur. After the bone is cut, a special apparatus is worn with pins that will pull the bone apart at approximately one millimeter per day. This causes osteogenesis, or new bone growth, in between the cut bone segments. A cast or brace may be required for several months after surgery to allow the new bone growth to harden and provide extra support.
Causes
Common causes include bone infection, bone diseases, previous injuries, or broken bones. Other causes may include birth defects, arthritis where there is a loss of articular surface, or neurological conditions.
Symptoms
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.
Diagnosis
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
Treatment for an LLD depends on the amount of difference and the cause, if known. The doctor will discuss treatment options carefully with you and your child before any decisions are made. It is important to note that treatment is planned with the child?s final height and leg lengths in mind, not the current leg lengths. Treatment is generally not needed if the child?s final LLD is predicted to be 2 centimeters or less at full height. However, the child should return to an orthopaedic doctor by age 10 for re-evaluation. Treatment is often recommended for LLDs predicted to be more than 2 centimeters at full height. If treatment is done, it usually doesn?t begin until the child starts walking. Possible treatment options include, A ?lift? in one shoe to level the child?s hips. This is often the only treatment needed for small discrepancies.
Surgical Treatment
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.
