What Is Leg Length Discrepancy? Kids with a leg length discrepancy have legs that are different lengths. This happens because the thigh bone (femur), shinbones (tibia or fibula), or both are shorter in one leg. What Are the Signs and Symptoms of Leg Length Discrepancy? Signs and symptoms of a leg length discrepancy depend on the cause and how much shorter one leg is. A small difference in leg length might not be noticeable at all. A bigger difference can cause a limp or pain. It can also lead to arthritis as an adult. Depending on how old a child is and the cause of the discrepancy, the difference may stay the same or get worse as the child grows. What Causes Leg Length Discrepancy? Leg length discrepancy can be present at birth (called congenital), but might not be noticeable until a child gets older. It also can develop when a child is older (called acquired). Causes of congenital leg length discrepancy include: fibular hemimelia (when a baby is born with a short or missing shinbone) focal femoral deficiency (when a baby is born with a short or missing thigh bone) hemihypertrophy (when one side of the body grows larger than the other) Causes of acquired leg length discrepancy include: a broken leg bone a bone infection An idiopathic leg length discrepancy is one where the cause isn't known. How Is Leg Length Discrepancy Diagnosed? To diagnose a limb length discrepancy, orthopedic specialists (doctors and other health care providers who treat bone and muscle problems): talk to the family and the child (if he or she is old enough) do a physical exam measure both legs watch how a child walks do X-rays How Is Leg Length Discrepancy Treated? If a child has only a slight difference in leg length, a shoe lift can even things out. This may be all some kids need. But if the difference in leg length is more than 1 inch (2.5 cm) or gets worse as the child grows, surgery can help. Kids may need more than one surgery as they grow. An option for kids who are still growing is epiphysiodesis (pronounced: ep-i-fiz-ee-uh-DEE-sis). In this relatively simple outpatient surgery, one or two of the growth plates in the longer leg are scraped or compressed with surgical plate and screws. A growth plate is an area at the end of the bone where new growth happens. The surgery slows or stops the longer leg from growing so the shorter leg can catch up. If a child has stopped growing, orthopedists can sometimes correct a leg length discrepancy by shortening the longer leg. This is done by removing a piece of bone from the longer leg. Limb lengthening surgery also can be done. In this surgery, the shorter limb is lengthened through a device on the outside of the body (an external fixator) or a device placed inside the bone (such as the PRECICE® limb lengthening device). This surgery requires a stay in the hospital and weeks to months of follow-up care and rehabilitation. What Can Parents Do? Fixing leg length discrepancy can take many years. Parents and the orthopedic care team play a big role in treatment. Here are things you can do: Talk to your child's care team about treatment and healing. Ask questions. Find out what each surgery is for and how to care for your child afterward. Take your child to all scheduled medical appointments. If your child is old enough, talk about treatments and what to expect. Include older kids in surgery decisions when you can. Looking Ahead Your orthopedic team will help you find the best treatment for your child. Take time to understand exactly what will happen at each stage of the treatment plan. This way, you and your child know what to expect and can follow the plan. Always remember that your orthopedic care team is there to answer any questions and help you get the best result for your child. Back to Articles Related Articles Fibular Hemimelia Babies who have fibular hemimelia are born with a short or missing fibula. Experts who treat bone problems have several options to help kids with a hemimelia. Read More X-Ray Exam: Leg Length Some kids may have significant differences in the length of their legs, a condition known as leg length discrepancy. This X-ray exam can help doctors determine the exact difference in leg length so they can decide on a treatment. Read More Limb Lengthening Surgery: Internal Lengthening Device Limb lengthening surgery is done when someone has a leg length discrepancy (one leg is shorter than the other). Sometimes this is treated with an internal lengthening device (a rod with a magnet). Read More Limb Lengthening Surgery: External Fixator Limb lengthening surgery is done when someone has a leg length discrepancy (one leg is shorter than the other). Sometimes this is treated with an external fixator. Read More External Fixator: Pin Care External fixators used for limb lengthening have pins that go through the skin and into the bone. It's important to know how to care for the pins at home to prevent infections. Read More Limb Differences Limb differences are when an arm or leg is not shaped in the usual way. Some don't need treatment. For those that do, doctors have a few options. Read More Developmental Dysplasia of the Hip Babies can be born with this hip problem or develop it soon after birth. Early treatment can help the hip joint grow normally. Read More Bones, Muscles, and Joints Without bones, muscles, and joints, we couldn't stand, walk, run, or even sit. The musculoskeletal system supports our bodies, protects our organs from injury, and enables movement. Read More Growth Plate Fractures Injuries to growth plates, which produce new bone tissue and determine the final length and shape of bones in adulthood, must be treated so that bones heal properly. Read More Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995-2021 KidsHealth®. All rights reserved. Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.