Unequal Leg Length

Unequal leg length, most commonly known as leg length discrepancy, is a common disorder in which both legs differ in length. The difference can be a centimetre to six centimetres or more. Greater discrepancy means your child’s way of walking and normal posture will be affected more. This can lead to other disorders such as functional scoliosis (abnormal lateral curvature of the spine), and hip, knee and ankle problems. There are various causes of unequal leg lengths which include:

  • Bone fracture which heals in a shortened position

  • Bone infection in children while they are growing can cause unequal leg lengths

  • Diseases of the bone that injures the growth plate; the region where growth in legs occur

  • Bone tumours and treatments designed to remove them 

Some causes are unknown, especially if the discrepancy is present at birth. The unequal leg lengths may not be noticeable when a child is born but they become more obvious as they grow.​

Symptoms of leg length discrepancy vary according to the alignment problems that result from it. Some common symptoms include:

  • Difference in leg lengths

  • Problems with posture

  • Problem in walking such as limping, toe-walking or rotation of the leg

  • Pain in the back hip, knee, and/or ankle​

​See one of our internationally trained doctors at the Children's Hospital Service Line at The Aga Khan University Hospital the only internationally accredited hospital in Pakistan, if you notice one of the above mentioned symptoms in your child. A referral to a Paediatric Orthopaedic Surgeon may be needed. ​
​Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

Your child’s doctor will begin the diagnosis with physical examination of the legs to measure their lengths. Usually, the doctor will measure the level of the hips while the child is made to stand barefoot. They may place blocks of wooden under the shorter leg until the hips align.

For precise measurements, the doctor may request X-ray of your child. If your child is still growing and has not yet reached the final height, the doctor may examine your child and take X-rays every six months to a year to check if the difference in legs increase or stays the same.​

Unequal leg lengths can cause hindrance in your child’s daily life. Therefore, to help them lead a normal life, our multidisciplinary team of staff at the Children's Hospital Service Line at The Aga Khan University Hospital strives to provide the best medical care possible.

Initially, the doctor will inquire about your child’s age, overall health and medical history followed by your personal preferences. You should also discuss with the doctor the procedures, therapies or medications your child will be most comfortable with in order to devise the best possible treatment plan for your child. The discussion between the doctor and the guardian is encourages as some treatments can be extensive and complex with high complication rates. Treatment options include:

  • Non-surgical treatment such as shoes lift for a length difference between two to six centimetres

  • Surgical treatments such as:

  • Epiphysiodesis in which the rate of growth of the long leg is slowed to allow the shorter leg to catch up. The procedure has its disadvantages including the irreversibility of the procedure, shortened stature and surgery of the healthy leg

  • Epiphyseal stapling in which the rate of growth is slowed temporarily by inserting staples on each side of the growth plate. Once the lengths are equal, the staples are removed

  • Bone resection in which a section of the bone is removed to equal out the lengths. This procedure can only be applied on children who have reached their final height

  • Bone lengthening in which an apparatus is connected to the shorter bone using wires, pins, or both, that encircles the leg. The bone is cut into two parts during surgery. After a few days the apparatus is used to gradually pull the bones apart, usually at a rate of one mm per day. This gradual pulling lead to bone regeneration between the two parts. After the completion of the process the bones are allowed to harden and then the apparatus is removed. A cast or brace may be required for some time after the procedure    ​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

​Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage

​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.