In many cases, it is seen that children are born with legs having different lengths. While on the other hand, differences in the legs can also occur due to certain conditions like injury or illness. For example, Polio can result in uneven growth of the limbs leading to limb length discrepancy.
Limb length discrepancy can occur in both arms and legs, but leg length discrepancy (Anisomelia) is more commonly treated because of its symptoms. If the difference in the limbs is not much or we can say noticeable, then no symptoms may be seen. Whereas, if the difference is more, the person may find it difficult to walk or run and experience pain while doing so as well. Limb shortening surgery is performed to correct the differences in the limb by either stopping or reducing the growth through the growth plate. This surgery often involves the use of orthopedic implants including various External Fixator Types like Ilizarov Ring Type External Fixator, Rail Fixator (LRS), and Dynamic External Fixators.
What are the Procedures Involved in Limb Shortening Surgery?
There are two types of surgical procedures that are used to correct limb length discrepancies:
- Limb-shortening surgery
Also known as growth plate fusion, epiphysiodesis is carried out in children and teenagers. This is because the epiphysiodesis procedure is used in growing people and the growth of children is known to occur till 18-20 years of age. In this surgical procedure controlled destruction of growth plate occurs at the end of the bones and suitable implants are applied to prevent the development of additional bones.
Limb Shortening Surgery
In limb shortening surgery, the surgeon removes some portion of thighbone or shinbone while applying orthopedic implants to hold other bone fragments in their right position to ensure correct & proper healing. It is noted that the surgeon can reduce the length of the femur to a maximum of about 3 inches and the tibia of around 2 inches.
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Which are the Ideal Candidates for Limb Shortening Surgery?
Ideal candidates for limb shortening surgery are said to be young adults and adults, or we must say people above 20 years of age. This is because the growth generally stops after 18 to 20 years of age. Thus, this makes it easy for the surgeon to decide how much bone length should be removed to correct the differences in the limb.
Diagnosis of Limb Length Discrepancy
In the case of children, differences in the length of the limbs (generally leg) may be diagnosed by the parents only by noticing the walking pattern of the child. This condition can also be noticed with the regular screening at school for scoliosis.
When it comes to the diagnosis by the doctor, he/she will first examine the medical history and health of the child. After this, the doctor will see the way the child walks to notice any abnormal movements while walking like bending of one knee or walking on the toes with the shorter leg. Imaging tests like X-ray and CT scan may also be suggested to measure the length of the limbs and identify the difference.
In growing children, the diagnosis procedure may be slightly different as the doctor may suggest waiting to confirm whether the difference between the limbs is increasing with growth or remains the same. In such cases, the doctor may indicate imaging tests and do a physical examination after every 6 to 12 months.