Congenital Limb Length Discrepancy

August 3, 2017 | By | Reply READ MORE...

– Dr. Ruchi Sanghvi

A child who has one leg shorter than the other from birth is said to have a condition known as congenital leg/limb length discrepancy. It is a source of concern and anxiety for the parents. The difference in the limb length can range from half inch up to two and a half inch. The greater the difference in the limb length, the more changes in the normal posture and walking pattern of the child.
Limb length discrepancy can be either :

  • Structural- this type occurs when femur (thigh) or Tibia (shin) bone on one side is physically shorter than the same bones on the other side.
  • Functional- this type occurs when the bone lengths are equal but the symmetry between the legs is disturbed by issues in the pelvis, hip, knee or ankle.

Congenital Limb Length Discrepancy

How is it diagnosed?

As the child grows the difference in the limb length becomes more evident. It can be diagnosed by radiographic views, measuring the limb length using a tape, evaluation of hip, knee and ankle contractures.

Congenital Limb Length Discrepancy

How can it be treated?

  • Non-operative method – This method can be used if the limb length discrepancy is less than 2 cm at maturity. A shoe lift is used on the side of limb shortening. However, it has poor cosmetic value for the child and family.

Congenital Limb Length Discrepancy

  • Operative method – This method can be used if the limb length discrepancy is more than 2 cm at maturity. Surgical technique is always used once the growth plates have matured completely. An osteotomy is performed and an external fixator is placed to during the lengthening phase.

Congenital Limb Length Discrepancy

Role of physiotherapy:

Post limb lengthening procedure, physiotherapy plays a vital role in maintaining the range of motion of the joints, prevention of muscular tightness or contractures in acute phase. Once healing is complete, more aggressive physiotherapy includes strengthening of the hip and knee muscles, maintaining normal alignment of the body and goal specific training like sports training.

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