Treatment for Leg Length Discrepancy (LLD)
How Can Leg Length Discrepancy (LLD) be Treated?
Treatment of leg length discrepancy (LLD) can be done surgically or non-surgically. Nonsurgical treatment are used in less severe cases where the leg length discrepancy (LLD) is below 2 cms, and requires lifting the heels with a lift, while surgical treatments are used in severe cases where the leg length is greater than 2 cms.
Non-Surgical Treatment for Leg Length Discrepancy (LLD)
In situations where the length is a minor and does not show any form of deformity, treatment may not be required. In this case, the difference may be below 1 inch. This condition requires a recommendation of a lift to the shoe to help the person walk, run and relieve pains that may be experienced at the lower back. The costs of these shoe lifts are not expensive therefore; you may decide to remove it if you find them inappropriate.
Orthotics for Treating Leg Length Discrepancy (LLD)
An Orthotic is a device made of Lunacell, inserted into a shoe to increase the length of the shoe. The lifts could be either a heel lift or a sole lift. Heel lift orthotics is used as treatment for people whose leg length are 1.5 cms and above. A heel wedge of the same size with the shoe is attached inside the shoe to lift the length of the shorter leg to become equal length with the longer leg.
On the other hand, a sole lift orthotics is used to equalize the lengths if the difference happens to be more than 2 cms. They lift will be made to extend below the shoe.
In this case, an extra heel is added to the sole of the shoe after the sole has been shaped to be the same shape with as the other shoe. Both shoes will now look exactly the same except for the extra sole added to the shorter leg.
These methods of treatments can help the person walk more comfortably and feel well supported.
Surgical Treatment for Leg Length Discrepancy (LLD)
In the surgical treatment, three methods can be used, and under the condition that the leg length discrepancy (LLD) is greater than 3 cms.
Leg Growth Equalization Method for Leg Length Discrepancy (LLD)
The first method requires that an equal or a near equal length is achieved by deliberately slowing down the growth rate of the longer leg for treating leg length discrepancy (LLD). It is necessary that the surgeons communicate to the patient, the degree of success that can be achieved with this method.
The person is subjected to go through a controlled X-ray requiring some incisions in the knee. The difference is not immediately corrected. The longer leg will grow in a very slow process while the shorter leg keeps growing faster to catch up with the longer leg. Gradually leg length discrepancy (LLD) will be decreased.
Growth normally ends by late teenage years, so it is intended that before the person reaches the stage when growth ends, leg length discrepancy (LLD) would have finally corrected.
There is a possibility of some complications to occur. In some cases, the leg length may be under-corrected or over-corrected. This can cause the person to become shorter than he/ she is supposed to be. The person may develop an unequal body size as a result.
Surgically Shortening the Longer Leg for Leg Length Discrepancy (LLD)
The second method requires shortening of the longer leg for treating the leg length discrepancy (LLD). About 3 inches of the femur and 2 inches of the Shinbone may be removed to make both legs equal in length in the surgical process.
Surgically Lengthening the Short Leg for Leg Length Discrepancy (LLD)
The third method requires that the shorter leg may be lengthened surgically for treating the leg length discrepancy (LLD). This requires the application of a device that is fixed externally to the shorter leg. A frame that looks like a scaffold will be attached to the bone using pins and (or) wires. There is a dial on these frames which is often turned many times a day to make a crack that creates tension. In 10 days’ time after the surgery, the bone begins to increase in length by 1 millimeter each day, and in a month, it would have increased by 1 inch.
If the leg is injured or was previously operated on, it may be slow in lengthening. Those whose blood vessels may have inherent deficiencies may also experience slow lengthening process of their bones. The lengthening period usually lasts for 3 months and the patient will wear the fixation till the bone is very strong and can safely support him/ her.
Other factors like health, age and rehabilitation activities may also slow the lengthening of the bone for the disease of leg length discrepancy (LLD).
There are risks involved in the surgical lengthening method for leg length discrepancy (LLD). They are:
- The nearby joints may become stiff.
- The bone may be slightly over corrected or under corrected during the surgery.
- The wires and pins which are inserted into the body may cause infections to the bones.
- The patient may be required to regularly visit the doctor and follow up regularly.
- The patient will need to undergo some rehabilitation the doctor prescribes.
Regular and thorough cleaning of the wires and pins are required after the surgery.
Whatever treatment procedure is taken, there are risks involved. An experienced doctor will explain the risks involved in each treatment, and the patient, parents and the doctor will together decide the best treatment to follow.
Coping with Leg Length Discrepancy (LLD)
Most patients with leg length discrepancy (LLD) usually do not have any restrictions to engaging in normal daily activities and they are able to do and achieve whatever they want. They may become emotionally and physically disturbed when they are subjected to series of surgical operations and constant visits to the doctor. The parents and the child need to be prepared to undergo these processes till the end so that good results will be achieved. Psychological counseling might also prove to be beneficial for both parents and children in the case of leg length discrepancy (LLD).
Nevertheless, records have shown that most patients have always responded excellently well with early and on time treatment.
Recovery Period for Leg Length Discrepancy (LLD)
The child and the parents should be adequately prepared to undergo series of treatments for leg length discrepancy (LLD) that will last for a long time. Normal recovery period for leg length discrepancy (LLD) spans between 6 months to one year. Sometimes process of treatment may lead to some complications, but treatments are often successful. The parents should cooperate with the physician to ensure positive outcome. Options may be given by the physician; whether the shortening or lengthening of one of the legs. Whichever is decided, the whole family should be committed to the end.
Prognosis for Leg Length Discrepancy (LLD)
A patient with leg length discrepancy (LLD) can perform any normal activities expected of a child. Early detection and treatment has always resulted in good treatment results. Severe cases of leg length discrepancy (LLD) may lead to development of serious hip, lower back and knee problems, if not treated early in the childhood.
Prevention of Leg Length Discrepancy (LLD)
It is not possible to prevent congenital leg length discrepancy (LLD), but if detected and treated early, other types of leg length discrepancies (LLD) can be prevented.
- Leg Length Discrepancy https://www.physio-pedia.com/Leg_Length_Discrepancy
- Leg Length Discrepancy—Treatment Indications and Strategies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477698/
- Leg Length Discrepancy https://www.hss.edu/condition-list_leg-length-discrepancy.asp