SUCCESSFUL LIMB LENGTHENING SURGERY FOR AN 11-YEAR-OLD PATIENT WITH CONGENITAL LIMB LENGTH DISCREPANCY

N.T.M (11 years old) and their family traveled from Da Nang to American International Hospital (AIH) for a medical consultation. Prof. René D. Esser, M.D., Ph.D., diagnosed the young patient with overweight issues and congenital limb length discrepancy, involving the left femur and tibia. Particularly, his left femur was 3.3 cm shorter than the right, and his left tibia was 3.4 cm shorter than the right. He had been exhibiting a limping gait and limited mobility for years. The family had previously sought treatment at multiple hospitals before proceeding with treatment at AIH under Prof. René D. Esser’s expertise.    

To correct the limb length discrepancy, Prof. Esser performed a left femoral lengthening surgery using an Orthofix external fixator. Five days post-surgery, N.T.M was discharged in stable condition, able to move the joints of his left leg. After nearly two months, the leg has successfully lengthened by 5 cm. He is now undergoing physiotherapy and regular follow-ups as recommended by the doctor. 

According to Prof. René D. Esser, limb lengthening in pediatric patients is more complex than in adults. Surgeons must predict the final discrepancy at the end of the child's growth period to ensure precise treatment. Therefore, early diagnosis and specialized treatment by experienced musculoskeletal experts are crucial.
 

► What is limb length discrepancy (LLD)?
 

 Limb length discrepancy is a condition characterized by a difference in the length of the legs. This condition can lead to difficulties such as limping, uneven gait, and over time, it may cause scoliosis, leg pain, and even lower back pain, which can limit mobility. Additionally, it can result in aesthetic concerns and negatively impact both the physical health and mental well-being of the affected individual. 
 

► Treatment options for congenital limb length discrepancy in children
 

Prof. René D. Esser explains that the predicted limb length discrepancy can be estimated by comparing the shorter affected leg with the longer unaffected leg. Treatment decisions require thorough diagnosis by orthopedic specialists and patient-family agreement before choosing the most suitable treatment method.
 

If the discrepancy is less than 2 cm, remains stable during growth, and does not cause significant limping or mobility issues, treatment may not be necessary.

Shoe Inserts: If the discrepancy is ≤ 2 cm and causes limping or mobility restrictions, using internal or external shoe inserts may be considered. Inserts ranging from 0.5 cm to 1 cm can be fitted inside most shoes, helping to reduce complications associated with moderate to severe discrepancies over a longer period of time.

Limb lengthening surgery: If the discrepancy exceeds 2 cm and significantly affects mobility in the long term, depending on each case, surgical intervention may be considered. Prof. Esser emphasizes that surgical planning must account for both the current and potential future discrepancies. The shorter leg is lengthened using an Orthofix external fixator. Since current techniques allow for only 5 cm of lengthening per surgery, multiple procedures may be required to minimize complications.
 

Prof. Esser also advises parents to schedule regular pediatric orthopedic check-ups to detect early structural bone issues and implement timely interventions.
 

To book a consultation with Prof. René D. Esser, visithttps://aih.com.vn/doctor/esser-rene-daniel-dr or call our hotline at (028) 3910 9999.