Acquired Leg Length Discrepancy

Intro

Treatment Options

Complications

Orthofix Solutions

Acquired Leg Length Discrepancy

Post-traumatic leg length discrepancies (LLD) are more common in adults, mostly caused by accidents and tumors: 1-3

  • Fractures: unlike in developmental causes, there is no risk of affecting the growth plates, since these are already closed and the bone is fully grown. However, severe fractures with loss of bone can cause bone (and consequently leg) shortening.
  • Bone healing problems: LLD can develop if the bone heals in a wrong or shortened position (malunion). In some cases, the patients cannot produce enough bone tissue to repair a fracture, and the bone does not heal at all (nonunion). This may be because the bone does not receive enough blood flow or because the fracture place is not stable enough.
  • Tumors: in adults, bone tumors can affect leg length because the tumor takes the place of healthy tissue as it grows. This can cause pain, bowing of the bone, fractures, and LLD.

These acquired causes of LLD affect the patients’ gait, muscles, and joints. 1

Icona SVG References

  1. Butcher CC, Atkins RM. (Ii) Principles of deformity correction. Current Orthopaedics. 2003;17(6):418-435. doi:10.1016/j.cuor.2003.10.001
  2. Ralston SH, Langston AL, Reid IR. Pathogenesis and management of Paget’s disease of bone. The Lancet. 2008;372(9633):155-163. doi:10.1016/S0140-6736(08)61035-1
  3. Jones MS, Waterson B. Principles of management of long bone fractures and fracture healing. Surgery (Oxford). 2020;38(2):91-99. doi:10.1016/j.mpsur.2019.12.010
  4. Chimutengwende-Gordon M, Mbogo A, Khan W, Wilkes R. Limb reconstruction after traumatic bone loss. Injury. 2017;48(2):206-213. doi:10.1016/j.injury.2013.11.022
  5. Krieg AH, Lenze U, Speth BM, Hasler CC. Intramedullary leg lengthening with a motorized nail: Indications, challenges, and outcome in 32 patients. Acta Orthopaedica. 2011;82(3):344-350. doi:10.3109/17453674.2011.584209
  6. Gordon, J. E., & Davis, L. E. (2019). Leg Length Discrepancy: The Natural History (And What Do We Really Know). Journal of pediatric orthopedics, 39(Issue 6, Supplement 1 Suppl 1), S10–S13.
  7. Applebaum A, Nessim A, Cho W. Overview and Spinal Implications of Leg Length Discrepancy: Narrative Review. Clin Orthop Surg. 2021;13(2):127-134. doi:10.4055/cios20224