September 24, 2018

Recognizing and treating limb length discrepancy

Pediatric Orthopedics

A difference between the lengths of the arms or legs is referred to as limb length discrepancy. Except in extreme cases, differences in arm length do not usually impact how the arms function and do not require treatment. Therefore, leg length discrepancy is a larger orthopedic focus.

What is limb length discrepancy?

A limb length difference may be a mild variation between the two sides of the body. This is not unusual; however, greater differences in length can affect a person’s quality of life.

Most commonly, the thighbone (femur) and shinbone (tibia) are affected by leg length discrepancy.  The femur and tibia do not grow from the center outward, instead growth occurs around the growth plates. If illness or injury damages the growth plate, the bone may grow at a faster or slower rate than the bones on the opposite leg.

What causes limbs to be unequal in length?

  • Some children are born with legs of different lengths
  • Previous injury to a bone in the leg
  • Broken bone
  • Bone infection
  • Bone disease such as neurofibromatosis
  • Neurologic conditions
  • Juvenile arthritis
  • Unknown


A discrepancy in leg length will usually become obvious to parents as they watch their child grow and begin to crawl and walk. Symptoms include:

  • Difficulties when walking
  • Walking with a limp
  • Tiring easily when walking
  • Low back pain

How are limb length differences diagnosed?

After a complete medical history review, your physician will perform a physical exam to look at how your child sits, stands and moves.

Your physician may recommend an X-ray or CT scan to confirm the diagnosis.



Treatment depends on the length of the discrepancy, the child’s age and the cause if known.

For minor limb length discrepancies, treatment is usually nonsurgical.

Nonsurgical treatment options

  • Observation
  • Wearing a shoe lift

Surgical treatment

Surgical treatment is designed to stop or slow down the growth of the longer limb, shorten the longer limb or lengthen the shorter limb. Your physician will determine the best course of treatment for your child based on their limb length discrepancy.

Learn more about pediatric orthopedic care at OrthoIndy.

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Megan Golden

By Megan Golden

Megan is the current Marketing Team Lead at OrthoIndy. Megan graduated from Ball State University in 2012 with a bachelor’s degree in public relations and advertising and communications studies minor and has been with OrthoIndy since June 2012.

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