Limb length discrepancy - DRHC Dubai Pediatric Orthopedic Clinic

By definition Limb length discrepancy is a difference between the legs or arms length. Differences in arm length usually do not affect the arms function and therefore do not require treatment.

Some children are born with legs of different lengths and that is normal variant and sometimes its according to illness or injury causes discrepancy in length to develop over time. Parents are usually the first to notice leg length discrepancy while the child start walking. Also it can be detected by school screening for curvature of spine(scoliosis screening). If your kid is facing the same problem you can consult our orthopedic specialist for children at DRHC Dubai.

For the orthopaedist with careful clinical exam it’s easy to notice and measure leg length discrepancy either by block testing( while the patient standing ,we add blocks under the short leg until the pelvis is level) or by tape measurement.

• Normally lower limb grows 23 mm/year, with most of that coming from the knee (15 mm/yr), growth continues until 16 yrs in boys and until 14 yrs in girls.
• Long bones growths from both ends (the growth plates)
• Leg length discrepancy can be from the femur  (thighbone) or from the tibia (shinbone).
• Slight shortness in leg length may not cause symptoms but significant shortness can cause limp, scoliosis, low back pain and finally joint arthritis.

Causes of Limb Length Discrepancy

Limb length discrepancy can be caused by a variety of factors, including:

• Previous fractures: In children, a broken bone can sometimes grow faster after healing, leading to an overgrowth. Alternatively, the bone can be shorter after a fracture if there is malunion or if the fracture affects the growth plate.
• Bone infections: Conditions like osteomyelitis and joint infections, especially in infancy, can contribute to limb length discrepancy.
• Neurologic conditions: Disorders such as cerebral palsy and polio can cause limb length discrepancies.
• Neurofibromatosis: This benign nerve sheath tumor can cause discrepancies in limb length.
• Inflammatory arthritis: Conditions like juvenile arthritis can lead to limb length discrepancies.
• Multiple hereditary exostoses (osteochondromas): This condition can cause discrepancies in limb length.
• Idiopathic causes: In some cases, the cause of the limb length discrepancy is unknown.

Treatment Options at DRHC Dubai

At DRHC Dubai, we consider the size of the discrepancy, the child’s age, and the cause of the discrepancy when determining the best treatment approach. Our treatment options include:

• Observation: For discrepancies less than 2.5 cm, we monitor the child at regular intervals until growth is complete to ensure there is no increase in the discrepancy.
• Shoe lifts: For some patients, wearing a shoe lift inside or outside the shoe can improve walking and running ability and relieve low back pain.

Surgical Interventions

For larger discrepancies, we offer several surgical options:

• Epiphysiodesis: This procedure slows down or stops the growth of the longer limb. It is a relatively simple surgical procedure performed through very small incisions, using x-rays for guidance. The goal is to reach equal leg length by the time growth normally ends—usually in the mid to late teenage years.
• Limb shortening: In patients who have finished growing, we can shorten the longer limb to immediately correct the discrepancy.
• Limb lengthening: For patients with significant discrepancies, we use either external or internal devices for lengthening. As the bones are gradually pulled apart (distracted), new bone will grow in the space created. Meanwhile, the skin, muscles, and soft tissues will adapt as the leg slowly lengthens.

With Internal fixation method here in DR.RAMI HAMED CENTER we use expandable metal rod implanted inside the bone. There is a magnetic gear system inside the rod and  handheld remote controller we passes on top of the skin which uses another magnet to slowly lengthen the internal device .This is a revolutionary idea for lengthening with less complication and short time of bed rest after surgery.

If you are in search of the best pediatric orthopedic surgeon in Dubai or children's orthopedic specialist in Dubai, then DRHC Orthopedic Clinic in Dubai offers you the top pediatric orthopedic surgeons with vast years of experience. To book an appointment call +97142798200.