Leg length discrepancy

What is leg length discrepancy?

Leg length discrepancy is a difference in length between the two legs. Small differences are very common and usually cause no problems at all. Larger differences can affect walking, posture and the spine. Causes include previous injury or infection affecting a growth plate, certain conditions present from birth, and some bone or growth disorders.

Signs and symptoms

• A limp or uneven walking pattern

• Walking on the toes of the shorter side

• One hip or shoulder appearing higher than the other

• A visible difference in leg length

How is it diagnosed?

Assessment involves a clinical examination and specialised X-rays to measure the difference accurately. Because the discrepancy can change as a child grows, monitoring over time is often part of the assessment, and predictions can be made about what the difference will be at the end of growth.

Treatment options

Minor differences may need no treatment, or simply a shoe raise. Larger discrepancies can be managed in several ways depending on the size and the child’s remaining growth, including guided growth (a small procedure that slows the longer leg at the right time so the shorter leg catches up), or limb lengthening or shortening procedures. The plan is tailored to the predicted final difference.

Outlook

With accurate prediction of final leg lengths, treatment can be planned and timed to achieve a balanced result by the time growth is complete.

When to seek advice

If you notice a limp, an uneven posture, or a visible difference in your child’s leg length.

This information is for general guidance only and is not a substitute for a consultation with Mr Wadia. If you are worried about your child, please seek medical advice.