ABSTRACT
A congenital vascular malformation (CVM) affecting the lower extremity (LE) can cause bone and/or joint abnormality, particularly leg-length discrepancy (LLD). LLD greater than 2 cm results in gait problems, scoliosis, and pelvic tilting, causing low back and joint contracture and pain. Therefore, patients with LLD greater than 2 cm should be treated. There are four types of treatments available for patients with LLD: (1) shoe-lift or brace fitting, (2) long-side epiphysiodesis, (3) long-side bone shortening, and (4) short-side bone lengthening.
For patients with 2–6 cm LLD, an optimal treatment can be decided by considering the severity of the LLD, age, patient's height, and underlying vascular problems. Shoe-lift or brace fitting is appropriate for patients with a small LLD without any other LE problems. Epiphysiodesis is a surgical option suitable for patients in growing age and which carries low complication rate and cost. The long bone shortening operation can be considered in adult patients. If the LLD is greater than 6 cm, a short bone lengthening operation can be considered. However, the bone lengthening operation is a time-consuming procedure and carries a high complication rate. Hence, treatment should be chosen very carefully, considering its advantages and disadvantages.
