Addressing Leg Length Discrepancy After Car Accident Surgery

Leg length discrepancy due to car accident?

Hello doctor, I had a car accident over a year ago and underwent two surgeries where metal rods were inserted.
The first surgery was the day after the accident, and the second was to correct a malalignment of my femur, which was not healing properly.
Since the surgery, my femur has been growing very slowly; it has not healed completely from November of last year until now.
Although there has been some growth, the rate is unusually slow.
In the past few months, I have just started using crutches to walk and noticed that my right leg is about 2 centimeters shorter.
I had a physical therapist measure it, and I also had X-rays taken.
However, the surgeon who performed the surgery is reluctant to provide a clear explanation since he is not the one who interpreted the X-rays.

Is there any way to treat the discrepancy in leg length? I understand that if the pelvis is misaligned, it can be manually adjusted, but what if that is not the case? I come from a farming background and cannot always wear shoes with height-increasing insoles; I often walk barefoot or in flip-flops in the fields, and the difference in leg length is quite noticeable, which is not aesthetically pleasing.
I frequently wear flip-flops as well.
Is there any way to address this issue? Thank you for your response.

A Cheng, 20~29 year old female. Ask Date: 2016/07/25

Dr. Yin Xinbei reply Rehabilitation

If it is not possible to continuously wear shoes with height-increasing insoles, the only option would be to undergo orthopedic surgery again.
If the metal plate has not yet been removed, it may be possible to perform femoral lengthening surgery simultaneously when the original plate is removed.
However, the success rate and risks should be discussed with an orthopedic surgeon.

Reply Date: 2016/07/25

More Info

Addressing leg length discrepancy after a car accident and subsequent surgeries can be a complex issue, particularly when it involves the healing process of bones and the alignment of the skeletal system. Based on your description, it seems that you have undergone multiple surgeries due to the injuries sustained in the accident, and you are now experiencing a noticeable discrepancy in leg length, with your right leg being approximately 2 cm shorter than your left.

Firstly, it is important to understand that leg length discrepancies can arise from various factors, including bone healing issues, malalignment, or even soft tissue injuries that may affect the overall function of the leg. In your case, the slow healing of the femur and the potential for malalignment following your surgeries could contribute to the discrepancy you are experiencing.

1. Bone Healing and Growth: After a fracture, the healing process can vary significantly from person to person. Factors such as age, nutrition, overall health, and the type of fracture can all influence how quickly and effectively bones heal. If your femur is healing slowly, it may be due to inadequate blood supply, infection, or other complications. It is crucial to follow up with your orthopedic surgeon to assess the healing progress through imaging studies such as X-rays or CT scans.

2. Leg Length Discrepancy: A discrepancy of 2 cm is significant and can lead to functional issues, including gait abnormalities and discomfort. If the discrepancy is due to a malunion (improper healing of the bone), surgical intervention may be necessary to correct the alignment. In some cases, a procedure called osteotomy may be performed to realign the bone and allow for proper healing.

3. Physical Therapy and Rehabilitation: Engaging in a structured physical therapy program can help improve strength, flexibility, and function in your legs. A physical therapist can provide exercises tailored to your specific needs and monitor your progress. They can also help you develop strategies to manage the discrepancy, such as gait training and strengthening exercises for the affected leg.

4. Orthotic Solutions: While you mentioned the discomfort of wearing height-increasing insoles, they can be a practical solution to manage leg length discrepancies. Custom orthotics can be designed to provide support and improve alignment without compromising your comfort. Discussing this option with a podiatrist or orthopedic specialist may yield a solution that allows you to walk more comfortably without the need for bulky shoes.

5. Surgical Options: If the discrepancy is due to structural issues that cannot be resolved through conservative measures, surgical options may be considered. These can include limb lengthening procedures, which involve gradually lengthening the bone using an external fixator or internal device. This is a complex process and requires careful planning and follow-up.

6. Monitoring and Follow-Up: Regular follow-up appointments with your orthopedic surgeon are essential to monitor the healing process and address any concerns regarding leg length discrepancy. They can provide guidance on the best course of action based on your specific situation.

In conclusion, addressing leg length discrepancy after a car accident involves a multifaceted approach that includes monitoring bone healing, engaging in physical therapy, considering orthotic solutions, and potentially exploring surgical options if necessary. It is crucial to maintain open communication with your healthcare providers to ensure that you receive the appropriate care and support throughout your recovery process.

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