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Limb Length: A Word From Your Podiatrist
Limb length discrepancy, known in the medical world as “anisomelia”, refers to the two hind limbs of unequal lengths. This orthopedic condition is of a common occurrence that may manifest itself in early childhood or as an outcome of some illness or injury that produces damage in the growth plate of the bones.
In majority of cases the affected bones are the femur and tibia. Most of the people are born with a minor degree of limb length discrepancy, but it is not often accounted for and, thus, goes unnoticed. If the difference of length is larger than 1 cm, the condition does become noticeable and can seriously hamper you from following a sportive activity schedule so as to compromise the quality & wellbeing of your desired lifestyle. This issue may also be confronted in adulthood after undergoing hip or knee replacement procedure.
It is worth notifying that greater the height of an individual, the greater might be the discrepancy level that turns its treatment all the more essential.
Limb Length: The Causative Factors
Limb length differences are caused due to the following reasons:
- Congenital Problem apparent at birth that increases progressively over time
- Post-traumatic Consequence whereby fractured or traumatized bones may heal in an incorrect way by overgrowing than the normal limb to cause the length difference
- Bone Infection, especially in early childhood as a potent causative agent
- Bone Diseases of varying types may give rise to this issue:
- Multiple Hereditary Exostoses
- Ollier Disease
- Juvenile Arthritis
- Neurologic Issues
Limb Length: Signs & Symptoms
Although the symptoms and their degree vary with the extent of discrepancy and the underlying cause, the typical symptoms can be listed as follows:
- Different Shoe Sizes owing to differences in feet
- Painful Sensation in the shorter limb, knee or lower back
- Limp Or Difficulty In Walking upon a length difference of 1 inch or above
- Altered Gait owing to a significant limb length divergence
- Ankle Issues such as pain or deformities occurring only in either foot
- Inclined Head Or One Shoulder to one side of the body while on feet
- Stress Fractures of bones in the affected limb in severe cases
Limb Length: Diagnostic Procedure By Your Expert Podiatrist
- Taking History
- Physical Examination
- Assessment & Evaluation Of Your Gait
- Using Imaging Techniques Like X-ray, CT Scan & MRI
Limb Length: Course Of Treatment
The treatment course may follow a nonsurgical or surgical approach based upon your shorter limb condition.
The Nonsurgical Option: Your expert NY podiatric specialist would go for the simpler, nonsurgical means of correcting the fault if the difference of lengths stands at 1 inch or less, without being associated to any form of limb deformities.
- Wait-and-See Option, especially in juvenile cases where the variance progress may come to a standstill altogether or the condition might just worsen
- Inserting Shoe Lifts within the affected leg shoe to equalize the length difference that would reduce the discomfort during walking or running
The Surgical Option: The surgical methodology follows a dual approach; the correction can be achieved either by limb shortening or limb lengthening.
- The Limb Shortening Procedure can be utilized in 2 different ways:
- Epiphysiodesis wherein the development of the growth plate of the normal, longer leg is caused to retard or cease altogether
- Limb Shortening Surgery wherein a portion of the longer bone is removed to match the length of the shorter limb, performed in grownup children and adults
- The Limb Lengthening Procedure can be utilized in 2 different ways:
- External Limb Lengthening comprising of cutting the shorter leg bone at 2 locations, surgically attaching an external fixator that is internally joined to the leg bone with pins & wires, and adjusted daily with the surgeon’s guidance until a significant change is observed
Internal Limb Lengthening comprising of cutting the affected bone and placing a metal within its hollow cavity to allow a natural, slow & gradual process of lengthening that is directly proportional to the limb movements, without any daily adjustments
Limb Length: The Associated Risks
As is true to generally all surgical procedures, there are certain types of risk factors involved with varying intensity and propensities. Some of these are jotted down beneath:
- Injury To Nerves & Blood Vessels
- Thrombosis (Formation Of Blood Clots)
- Tightened Soft Tissues & Stiffened Joints
- Dislocation Owing To Joint Instability
- Invasion By Infection
- Delayed Bone Union & Lengthening
- Recurrence Of Fracture In The Elongated Bone