Synonyms in a broader sense
Leg length difference, pelvic obliquityExamination of the leg length difference in Frankfurt English: different leg lengths
Definition
A leg length difference is understood to be a difference in the length of the legs. This phenomenon affects almost one third of the population and can remain undetected for a lifetime. However, if there are large differences, the person affected may experience problems.
In medicine, a leg length difference is a difference in length of the lower extremity from the hip to the foot. A distinction is made between the real leg length difference or anatomical leg length difference. Here, a difference in bone length can be determined.
In addition there is the functional leg length difference. This is caused by contractures (loss of length) of the muscles and the capsule-ligament apparatus or the malposition of individual joints. The therapies for anatomical and functional leg length differences are different.
The functional leg length difference is not treated with surgical limb lengthening. In addition to an intensive soft tissue treatment, a surgical soft tissue intervention may be necessary. The anatomical leg length difference can be caused by missing, delayed or accelerated growth. Furthermore, an existing leg length difference can be corrected conservatively with orthopaedic insoles. A differential diagnosis by means of a treadmill analysis is advisable.
Cause
Congenital/congenital malformations are initially considered to be the cause of an anatomical leg length difference. The congenital growth disorders are called osteochondrodysplasias. The disorder in this group of diseases can be located in the epiphyses, metaphyses, periostal or endostal.
This results in reduced or increased bone growth. Tumorous or tumor-like diseases of the lower extremity can also lead to an anatomical difference in leg length. Bacterial and non-bacterial inflammation can cause a reduction in bone mass and thus also be a cause.
Neuro-orthopedic diseases associated with paralysis can affect the supply of bone and thus its growth. The most common cause of anatomical differences in leg length is considered to be injury (trauma) to the lower extremity. These include bone fractures (fractures) and injuries to the growth plate (epiphysis). Other causes can be systemic diseases, where metabolic processes are altered, and radiation after cancer.
Symptoms
If there is a difference in leg length of more than 6-10 mm, the first symptoms appear in the affected person. As one leg is longer than the other, the hip tilts to the side with the shorter leg and a crooked hip axis is formed. This can lead to problems and pain when standing and walking and can also affect the spine.
The affected person compensates for the difference with a curvature of the lumbar spine, which in the long run manifests itself as pain and causes a limp in the gait pattern. When standing straight, the oblique hip axis also affects the shoulders, which also show an inclination to the side of the shorter leg. In order to compensate for the sloping shoulders, this often results in a simultaneous lateral inclination of the head. With children in the growth phase, the occurrence of a leg length difference is nothing unusual and should be observed first and foremost.
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