[mumball]

Hi,

Do most children with hemiplegia have different leg lengths and what are the physio's and orthotics doing to help the constant back, leg, knee and hip pain in both legs?

I ask this question as my son seems to not have any help (other than wearing a very built up (almost 2 inches)splint which doesn't really sit in his shoe properly. Are there any leg lengthening techniques available?

Is a shorter leg just an accepted part of being hemiplegic?

Any advice anyone?

Thanks Carol

[amy_louise]

mumball, on 24 November 2011 - 01:09 PM, said:

Hi,

Do most children with hemiplegia have different leg lengths and what are the physio's and orthotics doing to help the constant back, leg, knee and hip pain in both legs?

I ask this question as my son seems to not have any help (other than wearing a very built up (almost 2 inches)splint which doesn't really sit in his shoe properly. Are there any leg lengthening techniques available?

Is a shorter leg just an accepted part of being hemiplegic?

Any advice anyone?

Thanks Carol

Hello!

I'm 22 with left sided hemiplegia. My left leg is about 1/2 inch shorter than my right. It's always been that way. I think it's fairly common in hemiplegia, and my consultant said that it's actually helpful for my walking that my leg is shorter, can't remember why exactly, I think it stops it dragging along the floor if they were the same length. However, that being said, it does cause me pain after i've been walking a while in my lower back & left hip, because the leg has to be lifted higher to walk. I have a wedge in my shoe to try and even things up when I wear my splint, though I do find it weird because my 'good' leg ends up being a tiny shorter and it feels odd!

When I was 14, there was talk of scraping my growth plate of my 'good' leg to give the left one a chance to catch up. It's a fairly simple operation but for some reason it wasn't done?

It's a tricky decision to decide whether to operate I think. Obviously, if it's too big a discrepancy then it can cause skeletal problems. I suffer a lot from pain with my hemiplegia and knee/hip/back pain is a very complex issue in hemiplegia. I find it doesn't just affect the leg & arm but the back is involved as well. So it sometimes can be too easy to assume that the leg length difference might be wholly responsible for any pain in these areas. For example, tight hamstrings can cause hip pain, so it's difficult to know whether leg lengthening surgery would help pain. I would just make sure your child's consultant keeps an eye on the discrepancy and are aware of pain issues & they'll know whether it needs operating on.

[amy_louise]

amy_louise, on 24 November 2011 - 04:28 PM, said:

Hello!

I'm 22 with left sided hemiplegia. My left leg is about 1/2 inch shorter than my right. It's always been that way. I think it's fairly common in hemiplegia, and my consultant said that it's actually helpful for my walking that my leg is shorter, can't remember why exactly, I think it stops it dragging along the floor if they were the same length. However, that being said, it does cause me pain after i've been walking a while in my lower back & left hip, because the leg has to be lifted higher to walk. I have a wedge in my shoe to try and even things up when I wear my splint, though I do find it weird because my 'good' leg ends up being a tiny shorter and it feels odd!

When I was 14, there was talk of scraping my growth plate of my 'good' leg to give the left one a chance to catch up. It's a fairly simple operation but for some reason it wasn't done?

It's a tricky decision to decide whether to operate I think. Obviously, if it's too big a discrepancy then it can cause skeletal problems. I suffer a lot from pain with my hemiplegia and knee/hip/back pain is a very complex issue in hemiplegia. I find it doesn't just affect the leg & arm but the back is involved as well. So it sometimes can be too easy to assume that the leg length difference might be wholly responsible for any pain in these areas. For example, tight hamstrings can cause hip pain, so it's difficult to know whether leg lengthening surgery would help pain. I would just make sure your child's consultant keeps an eye on the discrepancy and are aware of pain issues & they'll know whether it needs operating on.

Ephiphysiodesis is the name of the procedure used!

[karenalice]

Hi Carol
my son also has a shorter leg length but only has his affected leg's shoe built up.nothing much being done by his physio either and he is like your son always in constant pain in his feet,legs and hips.As my sons upper thigh bone is the one that is affected think nothing can be done the orthapedic reg said if it was the lower bone they could have cut the bone in two put a cage onto the bone to keep it apart until new bone grows to fill in the gap but it is a major op and very painful.
Hope that helps a bit
karen

[rachel3]

Hi,

yes my 6 year old daughter has one leg 2 cm shorter than the other. She has a built up shoe, and her orthopaedic surgeon has mentioned putting a growth inhibitor in the unaffected leg when she's older so that the hemi leg can catch up. I haven't asked what it is exactly, as it's some years away, but adjusting leg length seems to be a fairly standard thing as far as I can gather.

Rachel

[amy_louise]

rachel3, on 24 November 2011 - 08:19 PM, said:

Hi,

yes my 6 year old daughter has one leg 2 cm shorter than the other. She has a built up shoe, and her orthopaedic surgeon has mentioned putting a growth inhibitor in the unaffected leg when she's older so that the hemi leg can catch up. I haven't asked what it is exactly, as it's some years away, but adjusting leg length seems to be a fairly standard thing as far as I can gather.

Rachel

Also to add to this, I think if the predicted LLD after growth is finished is 3cm then I think they feel intervening is beneficial.

[mumball]

Hi,

Thanks for your replies! Can I just ask though, where do you get your information? Is it offered when you are at a physio session? We are not told anything and only find things out through this and other websites. Our hospital completely missed our son’s Autism diagnosis and it was only when we took him to see another paediatrician because our current one had signed him off that he got referred to Great Ormond Street.

Infact I get the impression from all of the people at the hospital that we are wasting their time and they are not really interested in our son at all.

[amy_louise]

mumball, on 29 November 2011 - 12:20 PM, said:

Hi,

Thanks for your replies! Can I just ask though, where do you get your information? Is it offered when you are at a physio session? We are not told anything and only find things out through this and other websites. Our hospital completely missed our son's Autism diagnosis and it was only when we took him to see another paediatrician because our current one had signed him off that he got referred to Great Ormond Street.

Infact I get the impression from all of the people at the hospital that we are wasting their time and they are not really interested in our son at all.

Hi!

I get most of my information from my physio to be honest, in terms of pain issues & what treatment options are/ and what mechanisms are causing the pain. I found gait analysis was useful for getting info specific to me and my gait pattern. I think it's important to have a good relationship with your consultant. The one I have currently is very good, he keeps me involved in all the treatment options and gives me choices so I feel in control of what's happening. You have to be careful though I find with consultants/physios. Both my consultant and physio can disagree on what's causing pain & whether certain treatments would be useful. For example, my physio felt my sacroilliac joint was causing my hip pain & that I was suffering from sciatica. My consultant disagreed and said tight hamstrings were responsible. So who do you believe? I tend to side with my consultant.