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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!!!
One leg is shorter than the other: causes and types of shortening
It is very important to understand the type of shortening diagnosed, since this directly determines the tactics of subsequent treatment: True (anatomical) - when the bones of one limb are shorter than the bones of the other. Anatomical disorders can be associated both with previous diseases (poliomyelitis, osteomyelitis) and injuries, for example, an improperly healed fracture. Often, with such shortening, static scoliosis is formed, which is caused by a change in the length of the legs. The difference in length in this case is significant - it can be more than 1.5 cm and is visually clearly visible. Functional shortening is a condition in which the actual length of the legs is the same. However, due to anatomical or neural disorders in certain parts of the body, the muscles of the pelvis and lumbar region spasm and “pull” the thigh and leg upward. The length of the short leg decreases by no more than 1 cm.
Functional shortenings are more common than others. They can be associated both with dysfunction of the sacroiliac joints and with injuries (road accidents, sports, accidental falls) and non-traumatic (postoperative adhesions in the abdomen and pelvis, dysfunction of the skull bones, kidney prolapse, problems with internal organs) causes.
Only an osteopath can differentiate functional and anatomical disorders.
Etiological factors
ARDN
- Idiopathic developmental anomalies.
- Fracture.
- Epiphyseal end plate injury before skeletal maturity.
- Degenerative diseases.
- Legg-Calvé-Perthes disease.
- Cancer or neoplastic changes.
- Infections.
FRDN
- Shortening of soft tissues.
- Joint contractures.
- Ligament weakness.
- Axial curvatures.
- Foot biomechanics (eg, overpronation).
Why is shortening dangerous?
Both anatomical and functional disorders inevitably cause curvature of posture. This is logical and understandable, because the body has to adapt and seek balance. The curvature of posture, in addition to an aesthetic defect, also displaces internal organs, which usually negatively affects their functions. In addition, the gait also changes. If the limb is of different lengths (usually shortened), it inevitably begins to experience increased loads. And this, in turn, causes problems with joints - hip, knee, ankle. In addition, the difference in length leads to a shift in the center of gravity of the body towards the shortened limb, in which, as a result of overload, flat feet are formed. At the same time, flatfoot itself enhances and “complements” the anatomical disorder with a functional one, since the height of the longitudinal arch of the foot decreases. On one side, a pelvic distortion occurs with the formation of lumbar scoliosis.
An interesting fact established by our osteopaths. Unilateral spasm of the iliopsoas muscle, which most often results in one leg being shorter, is often only a reflex response of the body to dysfunction of the cranial (cranial) region.
The condition of one leg being shorter is the result of an anatomical or mechanical imbalance in the human body. Different leg lengths cause the development of scoliosis, misalignment of the hip joint, changes in the position of the vertebrae and chronic overload of the joints of the lower extremities. As a result of this, a person begins to experience manifestations of various clinical directions - pain in the back and joints, headaches and even disturbances in the functioning of internal organs.
RDN, shoe lift and low back pain
A shoe lift may improve low back pain if patients' low back pain is correlated with RDN (see differential diagnosis). It is important to gradually increase the corrective lift rather than adjusting a fixed percentage of the RDN. Shoe inserts appear to reduce (chronic) low back pain and functional disability in patients with RDI of 10 mm or less. It can be added to treatment (lower back exercises). The importance of exercise is that people with RDN have significantly lower ipsilateral quadratus lumborum muscle endurance compared to people without RDN. However, this is just the conclusion of one small observational study, and further follow-up is needed to examine changes in muscle endurance and strength in people with RDN.
What to do?
Treatment methods depend on the cause of the disorder: If one leg is shorter than the other for anatomical reasons, the orthopedist may recommend wearing a thin heel support and then refer you to an osteopath to correct the associated anatomical disorders. If there is a functional difference in leg length due to flat feet or an increase in the arch of the foot, active or proprioceptive insoles are prescribed. We manufacture liners using podoscan and based on visual inspection data. Insoles can improve blood circulation in the hip joint and increase the stability of the musculoskeletal system when walking. The inserts also relieve pain and prevent the progression of existing deformities. If the problem is caused by displacement of the pelvic bones, osteopathic treatment of this disorder is prescribed. Often the problems are associated with chronic overload of the hip joint as a result of changes in the axial balance of the body and/or tension in the periarticular tissues and muscles. The hip takes an anatomically incorrect position or is compressed, the articular elements experience overload.
During the examination, the osteopath will be able to determine the shift in the center of gravity to the leg and will detect areas of overload of the hip joint in one direction. Osteopathic correction of functional disorders will restore balance to the body, eliminate compression and tension of tissues, restore blood supply and innervation in the joint, and restore the anatomically correct position of displaced internal organs.
In addition to osteopathic correction, we will refer the patient to a physical therapy specialist. Therapeutic physical education will allow you to build correct body mechanics, increase the amplitude of leg movements, increase flexibility, and strengthen the muscles and ligaments of the whole body. An integrated approach allows not only to get rid of the problem, but also to eliminate other related disorders.
What treatment methods exist for different legs? Is it possible to adjust the length of the limbs?
In orthopedics, there are two standard types of treatment: 1) when the short leg is lengthened to a long leg; 2) when a long leg is shortened to a short leg. A short leg is made longer using an insole or the surgical method of distraction osteogenesis. Shortening of a long leg is usually carried out in childhood, when the human growth plate is still active. The growth rate of the long leg is inhibited, thereby aligning it with the short leg. In adulthood, only surgery to shorten the bone is possible. Today, every person with such a pathology can get rid of imbalances with the help of modern orthopedic technologies. The Ladisten clinic has been successfully using and improving them for more than 30 years. As a result of the operation, the patient will have his own formed bone tissue, natural and 100% biologically compatible, and the Veklich apparatus, which is an improved design of the Ilizarov apparatus, allows you to operate through small incisions in the leg and not wear bulky structures during the rehabilitation period. We are always happy to help you and make your legs look the same!
Your “Ladisten Clinic”.
Diagnosis of leg asymmetry in children
Doctors can diagnose leg asymmetry during fetal development.
In this case, immediately after the birth of the baby, doctors will begin to clarify the diagnosis, after which the baby will be prescribed treatment. If in the first months of life, during routine examinations, the orthopedist notices any deviations in the baby’s development, he will observe him and prescribe preventive treatment. If hip dysplasia is suspected at the age of three months, the baby will be prescribed an x-ray examination, which, in combination with ultrasound results, will give a definite answer about the presence or absence of this pathology in the baby. If the diagnosis of dysplasia is confirmed, the doctor will select a treatment regimen for the child depending on the severity of the pathology.
The mother can do simple tests for the presence of asymmetry in the baby’s legs on her own. To do this, you need to lay the baby on the changing table on his tummy and examine the femoral and inguinal folds - they should be symmetrical and of the same depth. Then you need to turn the child onto his back and again evaluate the depth and symmetry of the skin folds, and also make sure that the baby has no restrictions when abducting the hips, and the abduction process is not accompanied by a click or push. Asymmetrical skin folds of different depths and resistance or clicking when hips are abducted may indicate the presence of hip dysplasia.
Another test for the presence of dysplasia is to bend the child’s legs at the knees while lying on the back. If, when the baby bends, one knee is lower than the other, the presence of dysplasia can be assumed with a high degree of probability.
The next test is for the presence of muscle hypertonicity. For this test, you need to lay the baby on his back and give him the opportunity to grab onto the adult’s fingers. If the baby, grasping the hands of an adult, begins to actively, symmetrically and fully move his legs and try to pull himself up on his arms, then everything is in order. If, while moving, the baby’s legs constantly cross, we can assume the presence of hypertonicity. The presence of hypertonicity can also be indicated by frequent crying, trembling of the chin, excessive regurgitation, stiffness of movements when awake and constantly tucked arms and legs during sleep. The presence of such symptoms must be reported to the pediatrician, who will send the baby for a consultation with a neurologist.
Doctors carefully monitor the condition of the lower extremities after fractures in children and adolescents, and during treatment of a fracture, X-ray examinations can be ordered repeatedly to monitor the correct fusion of bones.
If the cause of the difference in the length of the lower extremities is a tumor, then even before the tumor leads to asymmetry of the legs, you may notice other alarming symptoms: fatigue, pain when walking, thickening of one of the lower extremities. These complaints should be a mandatory reason to consult a doctor.
Mass vaccination of children against tuberculosis has reduced the incidence of this infectious disease among children and adolescents to a minimum, but infection of immunocompromised children with tuberculosis is still possible in the case of close contact with a sick person. The first signs of the development of bone tuberculosis in children and adolescents are high fatigue, muscle pain, stooping, causeless lameness, and an increase in the volume of the affected limb after physical activity. To accurately diagnose tumors and tuberculosis, it is necessary to take x-rays and MRI.
Installation of an unsuitable prosthesis
The reason for limb lengthening after surgery is the implantation of endoprostheses with monoblock cementless legs without preliminary determination of the NDL and offset value. In such conditions, there is a very high probability of mismatch between the parameters of the prosthetic leg and the proximal femur.
To achieve joint stability, doctors have to lower the hip during surgery, which ultimately leads to lengthening of the leg.
When selecting a prosthesis, not only the offset and length of the leg are important, but also its shape, width, and some other parameters. For endoprosthetics to be successful, the implant must fit the proximal femur. This is difficult to achieve with monoblock legs.