Kids with a leg length discrepancy have legs that are different lengths. This happens because the thigh bone (femur), shinbones (tibia or fibula), or both are shorter in one leg.
Signs and symptoms of a leg length discrepancy depend on the cause and how much shorter one leg is. A small difference in leg length might not be noticeable at all. A bigger difference can cause a limp or pain. It can also lead to arthritis as an adult.
Depending on how old a child is and the cause of the discrepancy, the difference may stay the same or get worse as the child grows.
Leg length discrepancy can be present at birth (called congenital) but might not be noticeable until a child gets older. It also can develop when a child is older (called acquired).
Causes of congenital leg length discrepancy include:
Causes of acquired leg length discrepancy include:
An idiopathic leg length discrepancy is one where the cause isn't known.
To diagnose a limb length discrepancy, orthopedic specialists (doctors and other health care providers who treat bone and muscle problems):
Treating a slight difference in leg length can mean lengthening the shorter leg or shortening the longer leg. A shoe lift can even out small differences, and might be all that some kids need. But if the difference in leg length is more than 1 inch (2.5 cm) or gets worse as the child grows, surgery can help. Kids may need more than one surgery as they grow.
An option for kids who are still growing is epiphysiodesis (pronounced: ep-i-fiz-ee-uh-DEE-sis). In this relatively simple outpatient surgery, one or two of the growth plates (areas at the end of bones where new growth happens) in the longer leg are scraped or compressed with surgical plates and screws. The surgery slows or stops the longer leg from growing so the shorter leg can catch up.
If a child has stopped growing, orthopedists can sometimes correct a leg length discrepancy by shortening the longer leg. This is done by removing a piece of bone from the longer leg.
Limb lengthening surgery also can be done. In this surgery, the shorter limb is lengthened through a device on the outside of the body (an external fixator) or a device placed inside the bone (limb lengthening device). This surgery requires a stay in the hospital and weeks to months of follow-up care and rehabilitation.
Fixing leg length discrepancy can take many years. Parents and the orthopedic care team play a big role in treatment.
Here are things you can do:
Your orthopedic team will help you find the best treatment for your child. Take time to understand exactly what will happen at each stage of the treatment plan. This way, you and your child know what to expect and can follow the plan. The orthopedic care team is there to answer any questions and help you get the best result for your child.
Reviewed by: L. Reid Nichols, MD
Date Reviewed: Feb 3, 2022