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General Practice 2023

Síshort leg syndrome: how to identify and treat

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Síshort leg syndrome: how to identify and treat
Síshort leg syndrome: how to identify and treat

Short leg syndrome, scientifically called lower limb dysmetria, is a situation in which one leg is shorter than the other and the difference between them can vary from less than 1 centimeter to several centimeters. The greater the difference between the length of the two legs, the greater the discomfort of the person, since it ends up making locomotion very difficult.

The short leg can be classified as being true or false. A true short leg occurs when the leg bones are actually shorter, whereas a false short leg occurs when the length of the leg bones are equal, but there is an unevenness in the hip.

It is possible to cure the short leg, leaving both the same size, but the treatments vary according to its cause and, therefore, each case must be discussed personally with the orthopedist.

How to confirm a leg is shorter

It is usually easier to identify that one leg is shorter than the other when the difference is greater than 2 cm, since the whole body is misaligned. When the difference is less than 2 cm, the easiest way is to lay the person on their back and then ask them to bend their knees. If one knee is higher than the other, it is possible that the person has one leg shorter than the other.

Another way to confirm the length of the legs is by measuring with a tape measure or observing the hip level when placing the person on wooden platforms that measure 1 to 5 cm in height.

Still, to confirm the diagnosis it is very important to have X-ray exams, which will also help to identify the cause and better adapt the treatment.

How the treatment is done

The earlier short leg syndrome is discovered and the earlier treatment is started, the greater the chances of cure, especially if treatment starts in childhood.

When the difference between the length of the legs is equal to or less than 0.5 cm, there is usually no need for treatment, and it is common for most people to have this difference in adult life. However, when the difference is greater, the treatment can be done with:

  • Physiotherapy sessions to release fascia, stretch shortened muscles, correct scoliosis, and decrease pain and muscle weakness, for example;
  • Use of an insole that is placed under the heel of the shorter leg to equalize the height of the two legs. This insole must be placed inside the shoes when the shortening is up to 2 cm, but in greater height differences, custom-made shoes can be used;
  • Osteopathy and RPG sessions that are very effective in aligning the whole body and can cure false short leg;
  • Surgery for correction of the short leg being, especially indicated in case of true short leg with more than 2 cm. The doctor may also suggest another surgery called epiphysiodesis, which consists of stopping the he althy leg from growing.

The orthopedist can indicate what the height difference between the legs will be in adulthood, even when evaluating children, using a calculation that indicates what the height difference will be in the future. Knowing this value is important because whenever the person has more than 5 cm of difference, surgery is indicated.

Possible complications

Having one leg shorter than the other can lead to some he alth complications:

  • Difficulty walking;
  • Alterations in the knee, which can be turned inwards or outwards;
  • Appearance of small fractures, called stress fractures;
  • Development of scoliosis, as the spine adopts a wrong position;
  • Development of arthritis or osteoarthritis in the joints;
  • Back, shoulder and neck pain.

All these complications can be related to each other, because as one of the legs is shorter, the body will have to adopt incorrect compensatory postures, which over time can cause pain and inflammation.

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