Limb length discrepancy is a significant difference between the length of limbs, which can go as high as several centimeters or inches.
The human body in nature, is not symmetrical. It is therefore, not uncommon for slight differences to be noticed in the limbs while growing. One arm may be slightly longer than the other, and the leg may be few millimeters shorter, than the other. This is not usually a problem, especially for the arm, but if it extends a few centimeters longer, it can cause pains, difficulty in movement, which may lead to limb length discrepancy.
Most people diagnosed with limb length discrepancy consider going for the bone shortening surgery, to correct the unequal length of the limbs, or to make them close in order to manage the symptoms.
Diagnosis of Limb Length Discrepancy.
A difference can be noticed as soon as a child begins to walk. However, proper diagnosis can be conducted through the following ways:
- Physical examination by a medical doctor. This is usually done in the hospital where the patient will be asked to walk round a place and he’s been observed by a doctor.
- The patient medical history will be reviewed.
- Torture screening at the school of scoliosis (curvature of the spine), may also pick up discrepancy in leg length.
- Imaging studies such as x-rays and CT scans.
- Measurement of the difference in both limbs by a medical personnel. This is usually done by placing a wooden block on the shorter leg until the hip is balanced.
However, it is important to note that, If the patient is a child, the doctor may recommend waiting to see if the difference in the limbs lasts over time, whether it is increasing or remaining the same.
Treatment of Limb Length Discrepancy.
The treatment for limb length discrepancy is only surgery. There are two surgical procedures for it, and they are:
- Bone shortening surgery.
It is a surgical procedure that involves the destruction of growth plates. The growth plates are found between the joint of two bones. When they classify and harden, they are considered closed, and as such, growth is stopped, and the limbs can no longer grow. This procedure involves drilling holes in the growth plates, to prevent them from expanding and facilitating growth or the slow them down. Additional metal plate can also be added to prevent additional bone development.
This procedure is best used for children and teenagers, because their growth plate is still open. It is advisable that, this procedure is timed precisely so that the bone that is not impaired by surgery, will not surpass the length of the bone impaired.
The risks involved in this procedure include:
- Deformity in bone growth.
- Poor growth of bones overtime.
Bone shortening surgery.
This surgical procedure actually shortens the length of a bone. This procedure involves removal of a portion of the thigh, one (femur), or shinbone (tibia). Metal plate screws, or rods are used to hold the remaining pieces of bone together, until they heal. Healing can take a few weeks, and require limited movement or can be kept in full leg cast, until healing is complete.
However, the maximum length that can be removed from the femur is 3 inches, and the tibia is 2 inches. The length to be removed is determined by the length of the longer bone, that needs to be removed to make them equal.
This procedure is best used for young adults, and adults whose growth plates are closed, and have obtained their maximum height.
The risk in this procedure includes:
- Bones that heal out of alignment.
- Over or under correction.
Cost of Treating Limb Length Discrepancy.
The treatment of limb length discrepancy is an expensive. The both procedures are not common, and as such, only few doctors can handle it. They both run in tens of thousand, which is not surprising, as they require staying in the hospital for sometime. The insurance company may cover it, but it is advisable to call and find out.
Can Bone Shortening Surgery Reduce Height?
There is no procedure yet for reduction of height. However, the bone shortening surgery can have an effect in height, depending on the length difference that is being corrected, but no significant difference is usually noticed.
Bone Lengthening Surgery and Bone shortening surgery.
Bone lengthening surgery is used in cases of uneven bone Length, just like bone shortening surgery. They are both used to treat limb length discrepancy. The difference between the two is that, in bone lengthening surgery, length is added to a shorter bone; while in bone shortening surgery, Length is removed from a longer bone, to create equal or near equal limbs. The latter is however, more acceptable because, in the former, metal is added, and is has a lot of risks, and complications more than the latter.
It is always advisable to talk to a doctor when a noticeable differences in the limbs occur, whether in a child, or an adult, to ensure that the best medical treatment is given at the required time, to prevent future complications.