Shortening of the leg (true)

True leg shortening is the situation where there is an actual loss of the length of bone in the leg. Here the pelvis is level, the legs are parallel, but one of the legs is short.

True shortening can be caused by factors proximal or distal to the greater trochanters in the shorter leg, or, more rarely, factors which cause relative lengthening of the apparently good leg:

• factors proximal to the trochanter:
  • coxa vara: secondary to neck fractures; slipped epiphyses; Perthe's disease; congenital coxa vara
  • loss of articular cartilage from infection or arthritis
  • dislocation of the hip
    
    
• factors distal to the trochanter:
  • old fractures of the femur
  • old fractures of the tibia
  • growth disruption, e.g. polio, bone or joint infection, epiphyseal trauma
    
    
• factors causing relative lengthening in one limb:
  • increased vascularity stimulating bone growth, e.g. due to long bone fracture or tumour
  • coxa valga, e.g. following polio