Leg Length Differences

Most differences in leg length are normal. No one is perfectly symmetrical and a difference of up to 2 cm in adults is typical.

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Causes & Risk Factors

 If you notice your child’s leg lengths are unequal, it could be caused by one of the following:

• Normal differences in leg length
• Bone growth disturbances
• Infection
• Trauma
• Hip dislocation
• Clubfoot and other neuromuscular diseases
• Congenital abnormality (e.g. shortening of leg bone)

Differences in leg length can also be mistaken for scoliosis.

Symptoms & Types

• Difference in length of the legs
• Difference of knee, hips or shoulder height
• Limp

Diagnosis & Tests

Doctors will conduct a clinical examination by measuring leg lengths by a variety of techniques.

A radiographic examination will include standing x-rays of the entire length of both legs. These x-rays are often taken at yearly intervals to monitor the leg length discrepancy. X-rays of the wrist are sometimes taken to help predict the final difference in leg lengths.

Treatment & Care

Using the x-rays and clinical exam, your doctor will predict the estimated difference between leg lengths at the end of your child’s growth. Based on this prediction, treatment recommendations are made.

• 0-2 cm difference: no treatment or shoe lift
• 2-5 cm difference: if your child is still growing, the doctor may recommend stopping the growth in the longer leg
• >5 cm difference: your doctor may discuss a combination of recommending stopping the growth in the longer leg and lengthening the shorter leg

Shoe lifts:

• Leg length differences of less than 2 cm can be left untreated or a shoe lift can be used. With a small difference, there is no negative impact on the knees, hips, or back in the future.
• For larger leg length differences, the size of the needed lift may be too large to be put into the shoe and a custom shoe with a thicker in sole is made

Shortening procedures:

• The doctor will appropriately time when the growth in the longer leg will be stopped
• This procedure can be done in a variety of ways

If lengthening a leg is required, physicians have many procedures to choose from. 

For additional information, contact our Orthopedics department.