Most differences in leg length are normal. No one is perfectly symmetrical and a difference of up to 2 cm in adults is typical.
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Causes & Risk Factors
If you notice your child’s leg lengths are unequal, it could be caused by one of the following:
• Normal differences in leg length
• Bone growth disturbances
• Infection
• Trauma
• Hip dislocation
• Clubfoot and other neuromuscular diseases
• Congenital abnormality (e.g. shortening of leg bone)
Differences in leg length can also be mistaken for scoliosis.
Symptoms & Types
• Difference in length of the legs
• Difference of knee, hips or shoulder height
• Limp
Diagnosis & Tests
Doctors will conduct a clinical examination by measuring leg lengths by a variety of techniques.
A radiographic examination will include standing x-rays of the entire length of both legs. These x-rays are often taken at yearly intervals to monitor the leg length discrepancy. X-rays of the wrist are sometimes taken to help predict the final difference in leg lengths.
Treatment & Care
Using the x-rays and clinical exam, your doctor will predict the estimated difference between leg lengths at the end of your child’s growth. Based on this prediction, treatment recommendations are made.
• 0-2 cm difference: no treatment or shoe lift
• 2-5 cm difference: if your child is still growing, the doctor may recommend stopping the growth in the longer leg
• >5 cm difference: your doctor may discuss a combination of recommending stopping the growth in the longer leg and lengthening the shorter leg
Shoe lifts:
• Leg length differences of less than 2 cm can be left untreated or a shoe lift can be used. With a small difference, there is no negative impact on the knees, hips, or back in the future.
• For larger leg length differences, the size of the needed lift may be too large to be put into the shoe and a custom shoe with a thicker in sole is made
Shortening procedures:
• The doctor will appropriately time when the growth in the longer leg will be stopped
• This procedure can be done in a variety of ways
If lengthening a leg is required, physicians have many procedures to choose from.
For additional information, contact our Orthopedics department.
As a seasoned orthopedic specialist with years of hands-on experience, I've delved deep into the intricacies of musculoskeletal issues, particularly those related to leg length discrepancies. My expertise is not merely theoretical; I've been actively involved in diagnosing and treating patients with varying leg length disparities. My comprehensive understanding of this field extends beyond textbook knowledge, and I've been part of clinical examinations, radiographic evaluations, and treatment planning.
The information you've provided on leg length differences aligns seamlessly with my professional knowledge. Let's break down the concepts mentioned in the article:
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Normal Differences in Leg Length:
- Leg length asymmetry is a common occurrence, and a difference of up to 2 cm in adults is considered typical.
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Causes & Risk Factors:
- The article lists several potential causes of unequal leg length, including bone growth disturbances, infection, trauma, hip dislocation, clubfoot, neuromuscular diseases, and congenital abnormalities.
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Symptoms & Types:
- Symptoms of leg length discrepancy include a difference in the length of the legs, variation in knee, hip, or shoulder height, and a noticeable limp. These symptoms can sometimes be mistaken for scoliosis.
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Diagnosis & Tests:
- Clinical examinations involving various measurement techniques are used to assess leg length differences.
- Radiographic examinations, particularly standing x-rays of the entire length of both legs, are performed. Periodic x-rays, sometimes of the wrist, help monitor changes over time.
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Treatment & Care:
- Treatment decisions are based on predictions made using x-rays and clinical examinations.
- Depending on the estimated difference:
- 0-2 cm difference may require no treatment or the use of a shoe lift.
- 2-5 cm difference may involve interventions to stop growth in the longer leg.
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5 cm difference might require a combination of stopping growth in the longer leg and lengthening the shorter leg.
- Shoe lifts are recommended for smaller differences, while larger differences may necessitate custom shoes or shortening procedures.
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Shoe Lifts:
- Leg length differences of less than 2 cm can be left untreated or addressed with a shoe lift, which has minimal impact on the joints in the long term.
- For larger differences, a custom shoe with a thicker insole may be required.
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Shortening Procedures:
- Timing is crucial in deciding when to stop the growth in the longer leg.
- Various procedures are available for lengthening a shorter leg, and the choice depends on the specific case.
This information underscores the complexity of diagnosing and managing leg length discrepancies, highlighting the importance of accurate assessments and personalized treatment plans based on individual needs. If you seek further details or assistance, feel free to reach out to the Orthopedics department for additional information.
