Leg Length Correction (Leg Length Discrepancy)

Overview

Leg length discrepancy is a condition in which one leg is measurably shorter than the other. Even a modest difference can alter walking mechanics and place abnormal stress on the hip, knee, and spine, leading to chronic pain and accelerated joint wear. Discrepancies can be congenital, can develop during childhood growth, or can result from fractures, infections, or prior surgery.

At our San Diego practice, we provide comprehensive evaluation and treatment for patients with leg length discrepancy. Our orthopedic trauma surgeons have specialized training in limb lengthening and reconstruction techniques, using both external fixation frames and modern internal lengthening devices to achieve precise correction.

Causes

• Fracture malunion — a leg fracture that heals with shortening due to bone collapse or overlap
• Growth plate injury — damage to a growth plate during childhood can cause one leg to stop growing prematurely
• Bone infection — osteomyelitis during childhood can impair bone growth
• Congenital conditions — some patients are born with one leg shorter than the other
• Prior surgery — bone loss from previous procedures, including tumor surgery or revision fracture care

Diagnosis

Leg length discrepancy is assessed through physical examination and imaging. Standing X-rays of the full lower extremities allow precise measurement of the difference. In growing children, serial measurements help predict the discrepancy at skeletal maturity and guide the timing of treatment.

Treatment Options

Non-Surgical

• Shoe lifts — an insert or built-up shoe can compensate for mild discrepancies and relieve associated symptoms
• Observation — in children, serial monitoring may be appropriate if the discrepancy is expected to remain small

Surgical

• Bone lengthening — the shorter bone is cut and gradually distracted using an external frame or an internal magnetic lengthening nail, stimulating new bone formation in the gap
• Bone shortening — in certain situations, removing a segment of the longer bone and compressing the site may be a simpler approach
• Epiphysiodesis — in growing children, the growth plate of the longer leg can be slowed or stopped at the right time to allow the shorter leg to catch up

When to See a Doctor

If you experience a limp, hip or back pain, or have been told you have unequal leg lengths, contact our San Diego office for evaluation. An accurate measurement and individualized treatment plan can significantly improve your comfort and function.