Causes of Limb Deformity and Discrepancy
Limb deformity or leg length discrepancy can be present from birth (congenital) or acquired (a result of an injury, infection or tumor). Some of the conditions that can cause limb problems in a child or young adult include:
- Congenital conditions present from birth
- Osteogenesis imperfecta
- Bow legs
- Knock knees
- Infections of the bones and tumors
- Injuries involving the growth center of the bone
There may also be deformities that are a result of the soft tissues and not the bones, such as with arthrogryposis and burns.
Signs and Symptoms of Discrepancy
The symptoms of limb deformity can range from a mild difference in the appearance of a leg or arm to major loss of function of the use of an extremity.
For instance, you may notice that your child has a significant limp. If there is deformity in the extremity, the patient may develop arthritis as they get older, especially if the lower extremities are involved. Patients often seek medical attention due to the appearance of the extremity (it looks different from the other side).
Treatment for Leg Length Discrepancy
Treatment depends on what limb has the deformity and the amount of deformity present. For example, there may be loss of function of the leg or arm. Cosmetic issues may also be a concern for the patient and their family.
If there are problems with the arms, the goal is to improve the appearance and function of the arm. Treatment of leg problems try to correct the deformity that may cause arthritis as the child gets older. If the problem is leg length, where the legs are not "equal," the goal is equalization (making the legs the same length).
There are some limb deformities and length differences that are expected to improve on their own. These can simply be watched with the child’s growth and may not need treatment at all. Treatment may include the use of adaptive devices, prosthesis, orthotics or shoe lifts. If the problem is more severe and not treatable with these methods, then surgery may be necessary.
The type of surgery depends on the type of problem. Outpatient procedures may be used to alter the growth of the limb. This is often done through small incisions. If an outpatient procedure is done, your child can continue with most regular activities.
Other times, surgery may be very involved and require the use of an external device that is attached to the limb with pins and wires. This device may be left on for months to correct the deformity or lengthen the leg. If this type of surgery is required, your child will be making weekly visits to Cincinnati Children's.
Call Your Child's Doctor If:
If your child has a significant deformity or length inequality, call the Limb Lengthening and Reconstruction Center at Cincinnati Children's for a consultation.
It is best to have a doctor see your child early, before the problem has a chance to progress. If evaluated late, the problem becomes more difficult to treat, often making it difficult to completely correct the deformity or leg length issue.
If you need to reach the orthopaedic nurse before 4 pm Monday through Friday, call 513-636-4567
. After 4 pm and during weekends and holidays, call 513-636-4200
and ask the operator to page the orthopaedic resident on call.