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Leg (Limb) Shortness (Phocomely)

There being a length difference between left and right leg or between arms is called leg shortness (LS - Phocomely). In general, there being less than 5cm length difference between two arms do not cause a functional problem, apart from aesthetic. Due to this, mostly the length difference between legs will be talked about.

 

Reason

Undergone accidents: If a fractured bone mended without being reshaped to its normal shape, one leg will be shorter. This problem can generally occur in severe fractures where the bone is split into many pieces. During the childhood, in the fractures that injure the growth cartilage which the bone grows from (epiphysiolisis), since this tissue will be affected or due to some problems during the treatment, shortness and/or curvature in limbs can occur.

Bone inflammation: Especially the bone inflammations during childhood can, despite every treatment, cause shortness and/or curvature in the bone. Again inflammatory or rheumatism diseases of joints during the childhood can cause leg shortness.

Congenital bone diseases: Ollier disease, multiple exocytosis, neurofibromatosis and such congenital diseases can cause length differences between limbs.

Other: Inflammatory, rheumatism diseases and neurological problems during childhood can cause length differences between limbs. Another condition is one leg being normal and the other being more developed and longer (partial giantism).

 

Diagnosis

For this purpose, the patient’s arm and leg lengths between various points needs to be measured while lying down or standing. While standing, hips are made to stay parallel to ground by placing wooden blocks with 1cm height under the short side and shortness is determined according to block count. Also millimetric measurement and calculations with special length roentgens must be made.

 

Treatment

Non-surgical: For legs, putting fillers inside or below the shoe of the short side for differences below 2 cm is the most suitable treatment.

Surgical: For children, to equalise the length of both limbs, either the short side is lengthened or the long side is shortened. The psycisian should decide the suitable techique according to the underlying disease, the time left for height growing etc.