Limb Deformities, Leg Length Differences and Congenital Limb Deficiencies

Children who are born with congenital limb differences, or who develop limb deformities in childhood due to other causes, are a wide-ranging and diverse group.  

Every child and family have unique needs when it comes to surgical correction, reconstruction, lengthening, or even amputation, as well as brace or prosthetic management and physical therapy.  

Some of these diagnoses are very rare and may benefit from involvement of multiple specialists along the treatment path including genetics, endocrinology, neurosurgery, neurology, or plastic & reconstructive surgery, and rehabilitation medicine. At Lurie Children’s, these specialists work together to manage the best treatment for each patient.

Usually there are multiple approaches available to address a limb deformity, and our team approaches each child and family individually, acknowledging the unique needs of each deformity when coming up with a life plan for treatment. Our team works closely with our Pediatric Orthotics & Prosthetics program. Our surgeons also work closely with The Chicago Institute for Fetal Health to provide prenatal consultations of limb deficiencies when identified on prenatal ultrasounds.

What are limb deformities, leg length differences and congenital limb deficiencies?

Some of the many diagnoses we evaluate and treat include:

  • Leg length discrepancy
  • Deformity or growth abnormalities after infection or trauma (fractures)
  • Genu varum
  • Genu valgum
  • Miserable malalignment
  • Tibial torsion
  • Congenital femoral deficiency / Congenital short femur / Proximal Focal Femoral Deficiency
  • Fibular hemimelia
  • Tibial hemimelia
  • Congenital pseudarthrosis of the tibia
  • Posteromedial tibial bowing
  • Skeletal dysplasias and bony lesions (achondroplasia, enchondromatosis, neurofibromatosis, fibrous dysplasia, multiple hereditary exostoses, etc)
  • Radial deficiency/Radial club hand/Ulnar club hand
  • Blount’s Disease
  • Rickets

What causes limb deformities, leg length differences and congenital limb deficiencies?

Each of these conditions is fairly unique. Some come from trauma, infection, or bad luck, while others may come from genetic differences, mutations, or syndromes. Often there may be no identifiable cause for the limb difference.

How are limb deformities, leg length differences and congenital limb deficiencies diagnosed? 

Diagnosis of your child’s condition may involve imaging such as xray, ultrasound, computerized tomography or MRI, as well as genetic and laboratory tests.

What are the long-term effects of limb deformities, leg length differences and congenital limb deficiencies? 

Since each child, family and limb is unique, we work hard to develop a treatment plan customized to each situation to balance the best functional outcomes while considering the treatment burden and cosmetic outcomes for each child.

How are these conditions treated?

Surgical management requires a wide range of techniques depending on each individual child and can include:

  • Limb lengthening or shortening
  • Acute deformity correction (osteotomies)
  • Gradual corrections with guided growth techniques (hemiepiphysiodesis and epiphysiodesis)
  • Internal lengthening with motorized nails (ie; Precise nail)
  • Computerized external lengthening and deformity correction with frames (Taylor spatial or Hexapod frames and monolateral rails)
  • Joint (hip, knee and/or ankle) stabilizing procedures including PAO, ACL reconstruction,
  • Superhip/Superknee/Superankle reconstructions among many others
  • Amputations  
  • Combinations of the above

We work closely with our Orthotics and Prosthetics teams to get patients the right inserts, braces, or prosthetic limbs before and after surgical management to maximize a child’s ability to walk, run, and play.  

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