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My Child Has One Leg Shorter Than the Other, Can This Be Treated?

It's normal for children and adults to have a small difference between the length of their legs, but at what point is it considered a problem?

"Leg length discrepancy is when an individual's two legs are different lengths (measured from the hip to the heel)," says Christopher Makarewich, MD, a pediatric orthopaedic surgeon at University of Utah Health. "If your leg length difference is more than two centimeters, this is more likely to be a symptomatic leg length discrepancy."

What causes leg length discrepancy?

Leg length discrepancies are the result of one leg growing faster or slower than the other. This can be caused by many different things and is generally grouped into two categories: acquired or congenital.

  1. Acquired discrepancies are the result of something happening to the growth plates of the leg, such as an injury or infection, causing the growth plate to slow or stop growing.
  2. Congenital discrepancies occur when the child is born with one leg longer than the other and can be caused by genetic or developmental conditions. Sometimes we don't truly know the cause of the difference.

What are the symptoms of leg length discrepancy?

Often times, leg length differences do not cause pain or trouble in children. They can cause pain in the back, hips, knees, or ankles, but this is more common in adults. Leg length differences that are more than two centimeters are more likely to cause pain and put children at an increased risk of hip and knee arthritis later in life.

Is leg length discrepancy noticeable?

Leg length differences are sometimes noticeable as a limp or in the way a child stands or walks (such as standing on their toes on the shorter side or bending their knee on the longer side).

What are the treatments for leg length discrepancy?

Small leg length difference can be observed or treated with a shoe lift. Larger leg length differences may require surgery. Options for this include slowing down or stopping the growth of the longer leg or lengthening the shorter leg. The decision about which option is best for your child depends on the overall difference in lengths and the goals of the child and family.

"We have two main treatment goals for children with leg length discrepancy. One is to be sure that when their legs are done growing there is less than a two-centimeter difference. The second goal is to help children be pain free and active while they continue to grow.
Christopher Makarewich, MD

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