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Lengthening the thigh or lower leg
- This way you can independently determine the difference in your legs. After this you need to see a doctor!!!
What are the types of shortening?
Shortening of the legs occurs:
- congenital
- acquired
Congenital shortening is detected in children at an early age and gradually progresses. If the parents themselves suspect a problem, then you can determine the approximate difference in leg length yourself. This is the only thing you can do on your own. The next step is consultation with a specialist. Different leg lengths in a child can be a symptom of a wide variety of skeletal diseases, including serious ones. In some cases, urgent medical intervention is necessary.
Attention to children
The specialist notes that parents should pay special attention to their children. “Congenital limb differences are controlled by an orthopedist. The main thing for parents is to bring their child to medical examination on time. The doctor will guide the child and pay attention to any abnormalities. Parents should listen to their children and pay attention to their complaints - discomfort while running, walking, fatigue while walking, constant pain in the back, in the pelvic bones, etc.,” says Mark Ivanov.
Consequences and complications of different leg lengths
The difference in leg length leads to a number of pathological conditions:
- back pain;
- spinal deformity and pelvic distortion;
- deforming arthrosis and aseptic necrosis in the hip joint;
- stress fractures;
- disturbance of gait and statics;
- violation of ergonomics, muscle imbalance;
- associated injuries due to limited compensation options.
Distortion of the pelvis and deviation of the spine with different leg lengths of 6 cm. a - without compensation; b - with compensation of 3 cm; with 6 cm compensation.
The same amount of difference in leg length has a more detrimental effect on a child’s body than on an adult’s body. This is due to different widths of the pelvis. In children, the pelvis is narrow, so the centers of the femoral heads are close, so the angle of the pelvis and the deviation of the spine will be greater.
A complex of pathological disorders that develop due to differences in leg length is what some authors call “unequal leg length syndrome.” If left untreated, leg length differences can cause many functional compensatory conditions (eg, spinal deformity) to transform into irreversible fixed deformities (scoliosis).
S-shaped scoliosis formed as a result of an uncompensated difference in leg length of 10 cm in a 40-year-old patient
Treatment tactics for identifying different leg lengths
Congenital shortening of the legs in children, due to the fact that the bones of the lower limb are of different lengths, requires observation for 6-12 months in order to determine the rate of growth lag in the leg and, most importantly, to get answers to the following questions:
- to operate or not;
- at what age should the operation be performed;
- lengthen a shortened leg or shorten a longer one;
- if lengthened, by what amount, etc.
Acquired differences in leg length as a result of a fracture or damage to the growth plate require compensation as early as possible
Post-traumatic shortening of the right femur in a 15-year-old patient, which led to pelvic deviation and spinal deformity. Femoral lengthening resulted in complete recovery.
There is a misconception that you have to wait until you are 16-18 years old to have reconstructive surgery. In case of pronounced shortening (more than 3 cm), the operation must be performed as early as possible - at the age of 6-7 years, so that the child does not feel inferior at school.
True shortening in adults is most often associated either with diseases that remain from childhood, or belongs to the so-called category. acquired. As a rule, such “acquisitions” are the consequences of injuries or operations. Shortenings are often combined with post-traumatic deformities. Adults adapt much worse to this pathological condition and come to the idea of the need for surgical treatment earlier.
What is the principle of limb lengthening based on?
Regardless of the specific lengthening technique, the general principle of limb lengthening is based on the discovery of G.A. Ilizarov “The general biological property of tissues to respond to stretching with growth and regeneration.” Those. if the limb is gradually stretched in the Ilizarov apparatus (1 mm per day), then the muscles, blood vessels, nerves, and skin will gradually stretch and lengthen without losing their properties. In order to stretch the bone, it must be crossed. This procedure is called an osteotomy. With gradual stretching, the increasing distance between the bone fragments in the osteotomy area is filled with newly formed bone tissue - regenerate.
Tibia regenerate in the process of lengthening the tibia by 7 cm
We offer you the most modern methods of lengthening, which can significantly reduce the time of fixation with the Ilizarov apparatus and begin early rehabilitation (express methods with fixation with an intramedullary pin).
Concomitant diseases of the musculoskeletal system
Lower back pain
The literature data on this matter is very ambiguous. RDN appears to affect the lumbar spine, at least in part causing lumbar scoliosis (in 2021, Gurney et al. showed that RDN leads to pelvic tilt in the frontal plane). The lumbosacral facet joint angles become smaller on the short side. It is hypothesized that asymmetry of joint angles predisposes patients to osteoarthritis changes in the lumbosacral joints.
Hip pain
A longer leg may be a predisposing factor for the development of osteoarthritis of the hip joint. As the length of the femur increases, the area of contact between its head and the acetabulum decreases (+ 10 mm - 5% / + 50 mm - 25.1%). Combined with increased tone of the hip abductors caused by increased distance between their origin and insertion and increased ground reaction forces, the longer leg is at risk.
Stress fractures
The greater incidence of stress fractures in the tibia, metatarsals, and femur of the longer leg appears to correlate with the greater forces through the longer leg described above.
There appears to be an association with greater trochanteric bursitis, patellar positioning, and myofascial involvement of the peroneus longus muscle.
Photo gallery of works
Girl 14 years old. Shortening of the right lower limb by 6 cm. Lengthening the lower leg.
Boy 15 years old. Shortening of the right femur by 6 cm after injury. The thigh was lengthened using the Ilizarov apparatus
Woman 44 years old. Shortening of the right femur by 5 cm and external rotation are consequences of hematogenous osteomyelitis. We lengthened the femur and brought the axis to the correct position.
Boy 3 years old. Congenital shortening and valgus deformity of the left hip. The femur was lengthened and the deformity was eliminated.
Male 39 years old. Shortening of the right femur by 6 cm after a fracture and unsuccessful operations.
My goal
I will not tire of repeating: my goal, or mission, as it is now fashionable to say, is to help myself and you raise a healthy generation of people!
Sincerely, Doctor of Osteopathy of Europe Muhammad Rafikovich Kayumov.
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Prevention of leg asymmetry in children
Preventing the syndrome is easier than treating it. Simple preventive techniques will help reduce risks and shorten the period of recovery of the functions of the musculoskeletal system. Necessary:
- eliminate all pathogenic factors causing the anomaly;
- maintain correct posture;
- avoid physical overload and stress;
- strengthen the muscle corset (daily gymnastics, sports, swimming);
- boost immunity and activate the body’s adaptive and compensatory abilities (walks in the fresh air);
- to live an active lifestyle.
If family members have the syndrome, then the baby is at risk and needs consultation with an orthopedist or chiropractor. It is important to notice in time that one leg is shorter than the other in a child, so that later you do not waste money, time, and nerves on restoring the baby’s health and joy of life.
Prevention
You can prevent shortening of a child’s leg by following these recommendations:
- During pregnancy, mothers need to be observed at the antenatal clinic, monitor their health and not take medications without a doctor’s prescription.
- After the birth of a child, it is necessary to regularly see a pediatrician and orthopedist in order to promptly identify disorders of the musculoskeletal system.
- The child must grow up in favorable conditions, parents must provide the child with a balanced diet and moderate physical activity.
- If a child plays sports, training should be carried out taking into account the age and physical capabilities of the person.
In general, prevention consists of a healthy lifestyle for parents and children.
It is necessary to protect the child from heavy physical activity and promptly treat any diseases under the supervision of a specialist. At the first signs of leg shortening, you should immediately contact an orthopedist. Share:
Diagnostics and examination. How can you tell if one leg is shorter than the other?
If the difference is only 1-2 cm, then visually it may not be noticeable, since the anomaly is compensated by the tilt of the pelvis and the curvature of the spinal column. You can identify the deformation yourself. The baby should stand on a flat surface, freely, relaxed. The violation is detected due to its location at different levels:
- poles of the patella;
- popliteal fossa;
- protrusions of the hip joint - greater trochanters;
- the tips of the iliac bones - anterior and posterior.
When measuring deviations in a baby, he should lie down, his back is straightened, his legs are extended. If the leg is shorter, then the gluteal folds are located at different levels. And with dysplasia, there is an additional fold at the joint level. If there is a strong difference, you can lift the baby under the arms and compare the level of the feet.
The child in the photo has a difference in leg length of 2 cm
The doctor takes the same measurements not only at rest, but also during movement - flexion/extension of joints, muscle tension. A test for the presence of limb differences is also carried out using special wooden blocks of different thicknesses. They are placed under the leg until the pelvis is in a horizontal position, and then the height of the “stand” is measured.
It is impossible to diagnose the disease based on physical examinations alone. The cause and degree of progression of the disease can only be identified by supplementing the study with instrumental methods. X-rays of the legs in different projections will make it possible to identify structural changes in bone tissue and joints. Diagnosis of pathogenic processes and the condition of soft tissues is carried out using ultrasound, MRI, and CT. Dysplasia in a baby today is diagnosed using ultrasound at any age. Even if the baby is a few days old, an ultrasound examination is completely safe for him.
In a baby, one leg is shorter than the other due to infantile increased muscle tone. Muscle hypertonicity is detected using electromyography or MRI. Laboratory methods help to establish an accurate diagnosis. They help to identify the presence and type of infectious agent, the inflammatory process, and the level of immunity.
Analyzing the data obtained, the doctor develops treatment tactics. Only an orthopedist can tell you what to do if a child has one leg shorter than the other. Lack of treatment and improper therapy cause severe, most often irreversible, changes. It has been established that in people who have one leg shorter than the other, disability is a consequence of doctors’ errors in choosing treatment methods or the patient’s neglect of their health. Advanced short leg syndrome threatens to develop:
- secondary dysplasia;
- inflammatory diseases and joint destruction;
- pathologies of the spine.
In women, short leg syndrome can cause infertility or problems with childbirth due to compensatory distortion of the pelvis.
Symptoms
You can notice different leg lengths by the following visual signs:
- changes in gait and limping on one leg;
- knee joints at different levels;
- pelvic distortion towards the shortened leg;
- misalignment in the shoulder girdle due to a violation of the symmetry of the spinal axis (one shoulder is higher than the other);
- asymmetry of the spine;
- pain and discomfort in the legs.
In addition to the symptoms described above, the patient also has clinical manifestations of the underlying disease, which became the root cause of the different lengths of the lower extremities.
In approximately 65% of patients, the following lengthens:
- distal (remote) part of the femur – in 37% of cases;
- proximal (closer to the knee) part of the tibia of the leg - in 28% of cases.
As the pathology progresses, signs of postural disorders and pathologies of internal systems and organs appear. When performing radiography and ultrasound of the chest and abdominal cavity, displacements of anatomical structures and prolapse of organs (for example, nephroptosis, prolapse of the stomach) are revealed.