If your child’s leg length discrepancy will be less than two centimeters at the end of growth, your physician may prescribe a shoe insert. If your child has some difficulties with walking, running, or back pain, shoe inserts may help to alleviate some of these symptoms. Most children with this size of discrepancy never experience symptoms.
If the leg length discrepancy is larger, surgery may be required. For medium sized discrepancies, there are small surgical procedures which slow down the growth of the opposite leg so the shorter side can catch up. Correction in the difference in length with this procedure is not immediate, but will be gradual over 1–2 years. Timing for this procedure is important to reach equal leg lengths by the end of growth in mid-teens.
For large sized discrepancies, more complicated surgical procedures can be performed, such as shortening the longer leg and lengthening the shorter leg. The bone is lengthened using a device called an external fixator. A frame is connected to the bone pins and wires. At home, the patient or the family turns knobs or screws on the frame to create length in the bone. To gain one inch, it usually takes 3 months. There are significant risks of this procedure, such as infection, stiffness to adjacent joints, and over or under correction. This form of treatment requires regular follow up visits with your orthopaedic surgeon, cleansing the pin sites regularly, dialing out the frame several times each day, and possibly rehabilitation.
In extreme cases where the leg is very short, lengthening may not be an option. These situations, fortunately, are rare.