Leg Length Discrepancy Surgery
Short answer
Leg length discrepancy means one leg is shorter than the other. Small differences are common and often need only a shoe insert, but larger differences can cause limping, back pain and hip problems and may be treated with surgery. The shorter bone can be lengthened with the same techniques used in cosmetic limb lengthening, and the Ilizarov frame is also used for medical cases.
What is leg length discrepancy?
Leg length discrepancy (LLD), also called anisomelia, is a difference in length between the two legs. The difference can be in the femur (thigh), the tibia (shin) or both. It can be present from birth or appear later, for example after a fracture that healed short, an infection or a growth plate injury in childhood.
Symptoms
• Limping or walking on the toes of the shorter leg.
• Back, hip or knee pain.
• A tilted pelvis or a curve in the spine when standing.
• Uneven wear of shoes.
How it is diagnosed
The surgeon examines you and measures the difference on standing X-rays of the whole leg. The X-rays also show the mechanical axis of the leg, which matters for planning (see bow legs correction and the mechanical axis).
Treatment options
• Small differences: a shoe lift or insert is often enough.
• Larger differences in adults: lengthening of the shorter bone.
• Combined problems: lengthening can be combined with correction of the bone axis.
How lengthening equalizes the legs
The technique is the same as in cosmetic lengthening: a controlled cut in the bone, a latency phase of 5 to 10 days, lengthening of about 1 mm a day, and consolidation of the new bone. Depending on the case, the surgeon may use LON, PRECICE or FITBONE, or the Ilizarov frame, which we use for medical cases. Read How does limb lengthening work? and internal vs external lengthening.
Recovery
Recovery follows the same steps as cosmetic lengthening, with physiotherapy 6 days a week during your stay and free, unlimited remote physiotherapy follow-up after you go home. See the recovery timeline.
Common causes
• Congenital differences present from birth.
• A fracture that healed with shortening.
• A growth plate injury or infection in childhood that slowed the growth of one bone.
• Conditions that affect one side of the body, or previous surgery.
Why treat it?
Over time, walking with uneven legs can tilt the pelvis, curve the lower spine and put extra load on the hip and knee of the longer leg. Many people with a larger difference also tire faster when walking. Equalizing the legs aims to improve walking, comfort and posture.
How much can be gained?
The same safety limits apply as in cosmetic lengthening: up to about 8 cm in the femur and up to about 6 cm in the tibia in one stage. Larger differences may need lengthening in both bones, in stages. The surgeon plans the amount from your X-rays.
Planning: length and axis together
Because many patients with unequal legs also have a deviation of the leg axis, the surgeon checks the mechanical axis on full-length X-rays and plans the lengthening so the leg ends up both equal and straight. See bow legs correction.
Your stay
The stay, physiotherapy and follow-up are the same as for cosmetic lengthening: about 3 months in Istanbul for most lengthening plans, physiotherapy 6 days a week, and free remote follow-up afterwards. See staying in Istanbul.
Living with unequal legs
Many people with a leg length difference have adapted for years, for example by bending the knee of the longer leg or standing on the toes of the shorter one. These habits can tire the muscles and joints. After equalization, physiotherapy helps you relearn an even walking pattern and strengthen the muscles that were working differently.
Get an assessment
Send us your standing leg X-rays and health history on WhatsApp (+90 533 016 45 62) for a free assessment with our surgeon.
FAQ
How much leg length difference is normal?
Small differences are common and often cause no problems. The surgeon assesses whether your difference needs treatment.
Can adults have leg length discrepancy surgery?
Yes. In adults, the shorter bone can be lengthened.
Which method is used for unequal legs?
LON, PRECICE, FITBONE or the Ilizarov frame, depending on the case. The surgeon recommends the method after examining you.
Can the axis of the leg be corrected at the same time?
In many cases lengthening can be combined with correction of the bone axis.
How long is the recovery?
It depends on how much length is needed. Lengthening goes at about 1 mm a day, followed by consolidation of the new bone.
Is the price the same as cosmetic lengthening?
Prices are packages per method. Send us your X-rays for a personal quote, as medical cases can need additional planning.
Related pages
How Does Limb Lengthening Work?
Internal vs External Limb Lengthening