LIMB LENGTH DISCREPANCY
When the limb length difference causes back pain or exceeds 2 cm (¾ of an inch) then treatment can and likely should be offered. A shoe lift, slowing down the growth of the opposite long limb in children, using external devices to lengthen or using internal rods to lengthen the short bone are all treatment options. There have been so many incredible advances making limb lengthening safe and doable even for very large discrepancies.
A minor leg length discrepancy that does not affect a child’s mobility or is not associated with any other conditions may not require any treatment. Shoe lifts may be recommended for smaller discrepancies. Surgical treatment such as limb-lengthening surgery is only recommended in severe cases. Modalities such as internal lengthening rods called Stryde Nails have revolutionized the care and allow even weight bearing while lengthening.
During limb lengthening, physical therapy is essential to stretch and maintain joint health. I cannot emphasize this enough.
GENU VARUM (BOWED LEGS)
Naturally occurring mild cases of bowed legs in young children should remain under observation but will typically improve without intervention as the child grows. Bracing or casting can be effective for early stage Blount’s Disease and rickets can be managed with medication.
Surgical intervention is only considered for children whose bowed legs are resistant to non-surgical treatment and persist past the age of four.