Leg Length Discrepancy

What is a leg length discrepancy?

Leg length discrepancy means one leg is longer than the other. Discrepancies as small as a few centimeters can set off a chain of events, causing your child to walk and stand differently, which can lead to hip, knee, and/or ankle problems, and can lead to functional scoliosis (a curve in the spine caused by an underlying condition). Leg length discrepancies can be congenital (from birth). They also can be caused by bone disease, bone tumors, the treatments used to eliminate bone tumors, injuries that don't heal properly, and a number of other causes.

There are generally two kinds of leg length discrepancies:

  • Structural discrepancy. This occurs when a leg bone is shorter than its corresponding bone in the other leg. For example, the thigh bone (femur) or the shin bone (tibia) is sometimes shorter in one leg.
  • Functional discrepancy. This occurs when a condition above the leg causes the discrepancy. For example, a hip dislocation can cause this kind of discrepancy.

What are the symptoms of a leg length discrepancy?

Because children's bodies respond differently to leg length discrepancies, symptoms can vary. Common symptoms include:

  • Obvious differences in length. While a discrepancy is not always obvious, if you are aware of a discrepancy, consult a physician.
  • Problems with posture or gait. This might include limping, rotating the leg while walking, or toe-walking.
  • Pain. The pain may occur in the ankle, knee, hip, or back.

How is a leg length discrepancy treated?

There are some nonsurgical treatments, such as orthotics, but often surgery is necessary to correct the discrepancy. Because children are still growing, the goal of surgery is not to correct the leg lengths for the current height of your child but to ensure leg lengths will be equal when your child is finishing growing. Often, this means your orthopaedic surgeon will need to take a series of measures over the course of 1-2 years in order to accurately predict your child's future height.

Each type of surgery for leg length discrepancy has its advantages and disadvantages. Options include:

  • Epiphysiodesis. In this surgery, a bony ridge is fastened to the growth plate of the longer leg, preventing the leg from growing more and allowing the shorter leg to catch up.
  • Epiphyseal stapling. In this surgery, staples are inserted into the growth plate of the longer leg, which slows down its growth.
  • Bone resection. In this surgery, a section of bone is removed from the longer leg in order to match the size of the shorter leg.
  • Leg lengthening procedures. Procedures to lengthen the shorter leg provide a child with the ability to reach his or her maximum height, but they also are technically difficult procedures, involving extended and painful physical rehabilitation and sometimes involving complications, such as wound infections, dislocations of the hip or knee, and other problems.

The best surgery for your child will depend on many factors, such as the size of the discrepancy, whether your child is finished growing, and other factors. Your orthopaedic surgeon will work closely with your family to help you make the best decision for your child's unique needs.

About surgery for leg length discrepancies at Children's

The surgeries for leg discrepancies are performed by the accomplished pediatric orthopaedic surgery team at Children's. Orthopaedic surgery teams at Children's provide next-generation care to children from throughout the Upper Midwest and consistently perform some of the most cutting-edge surgical procedures available, including minimally invasive surgery, when appropriate. Leg discrepancy surgeries are performed at Children's – Minneapolis and Children's - St. Paul.

  • If you are a family member and you'd like to make an appointment at our clinic locations in Minneapolis or St. Paul, please call Children's Orthopaedic Clinic main line at (651) 220-5700.

  • If you are a health professional looking for a consultation or referral information, please call Children's Orthopaedic Clinic main line at (651) 220-5700.