Unequal leg length

Unequal leg length (ULL), also known as leg length discrepancy (LLD) or leg length inequality, is a condition where the lengths of the legs are not equal, resulting in one leg being shorter than the other. This condition can affect individuals of any age and can result from various causes, including congenital issues, diseases, or injuries. Unequal leg length can lead to a range of complications if not properly managed, including problems with posture, walking, and increased risk of injuries.

Causes

The causes of unequal leg length can be broadly categorized into two groups: structural and functional.

• Structural discrepancies occur when the actual bones of the legs are of different lengths. This can be due to congenital conditions such as Congenital Femoral Deficiency or Fibular Hemimelia, growth plate injuries, or diseases that affect bone growth like Osteomyelitis.
• Functional discrepancies arise from conditions that affect the leg's alignment or function without altering bone length. These include issues like Hip Dysplasia, muscle contractures, or different conditions that cause a person to walk in a manner that makes one leg function as if it were shorter.

Symptoms

Symptoms of unequal leg length can vary depending on the severity of the discrepancy and the individual's activity level. Common symptoms include:

• Abnormal gait, such as limping or toe-walking
• Pain in the lower back, hip, knee, or ankle
• Postural problems, including tilting of the shoulders or pelvis
• Increased susceptibility to injuries due to compensatory mechanisms

Diagnosis

Diagnosis of unequal leg length typically involves a physical examination and medical history review. Healthcare providers may use various methods to measure leg length and assess the discrepancy, including:

• Direct measurement of the length of the legs from the hip to the ankle
• X-ray imaging to evaluate bone length
• CT scan or MRI for more detailed views, especially in cases of soft tissue factors contributing to functional discrepancies

Treatment

Treatment for unequal leg length depends on the cause, severity, and the patient's symptoms. Options include:

• Observation: In cases of minor discrepancies without significant symptoms, regular monitoring may be all that is needed.
• Shoe lifts or orthotic devices: For mild to moderate discrepancies, inserting a lift in the shoe of the shorter leg can help balance leg lengths and alleviate symptoms.
• Physical therapy: Exercises to strengthen muscles and improve flexibility can help manage pain and improve function.
• Surgery: In cases of significant structural discrepancies, surgical options such as limb lengthening or shortening procedures may be considered.

Prognosis

With appropriate management, individuals with unequal leg length can lead active, healthy lives. Early detection and treatment are crucial to prevent complications and improve quality of life.

See also

• Orthopedics
• Pediatrics
• Physical therapy