Owing to my hip dysplasia and somewhat ‘wonky’ pelvis, my legs have always been different lengths. But that leg length discrepancy has varied over time. If you’ve ever had a go at cutting your own fringe (never advisable I find it always leads to endless tinkering one side then the other until it’s too late and you’re scalped…) then you will understand the journey my legs have been on. Every so often leg length becomes an issue, and by replacing my knee and giving me a straight right leg for the first time in my life, my left leg is once again too short!
Most people with DDH have some form of leg length discrepancy and managing the impact of that is much discussed in forums such as those managed by Steps Charity or the International Hip Dysplasia Institute. Even a small difference can cause back problems that we don’t need on top of our hip challenges. There are different ways to manage this and two I’ve experienced; adaptation of my shoes (external raises or orthotics inside the shoe) or leg lengthening surgery.
I finally got to walking aged 3 ½ after a fair amount of surgery and I gradually grew quite lopsided. Whilst my left leg looked shorter – and standing I would lean significantly to one side – the problem wasn’t that the leg itself was shorter. Rather that it had been set so much higher (because the socket was missing) and so it rested close to the top, not the bottom of my pelvis.
In 1988, at the age of 16, I had my left femur lengthened. This was a relatively new surgery developed to help people with restricted growth like dwarfism. It was also being used for people like me who had significantly different leg lengths. This surgery essentially broke my femur in two, screwed in an external fixator either side of the gap which I then turned ¼ mm every day for several weeks with an Allen Key (yep, looked just like the ones we dread from Ikea!). This lengthened the gap, into which new bone grew. Once the new bone hardened the pins were simply unscrewed, the wounds healed quickly, and I had a longer left leg. It didn’t hurt to turn, to be honest the most painful part was cleaning the pin sites which would get infected (a bit like soreness of a new pierced ear or belly button) and I had some sciatica as the nerves and tendons had to stretch to fit.
What that surgery gave me, aged 16, was my first ever experience of standing almost straight. My shoulders were level, and importantly for my singing, I could expand both sides of my lungs equally. My voice tripled in size overnight! I was also able to walk with much less of a limp until my late 20s until my left hip was so worn and arthritic my pelvis was shifting and length was again an issue. This time it was managed by adding an external shoe raise to my left shoe (between the shoe and the sole).
The downside of the lengthening surgery came when I had my hip replacement in 2003. Normally in cases like mine a surgeon will address the leg length discrepancy whilst fitting the new hip and so level the hips. But of course, now, my left leg was too long! By now you should understand the fringe-cutting analogy – LOL!
What it did do, is reset the hip to where it was after my leg lengthening surgery, and so I no longer needed the external shoe raises, but a much shallower inner orthotic. This was great as it’s more flexible – the orthotic can be moved from shoe to shoe, rather than being able to wear only the shoes that have been adapted.
So why am I writing about this now? ….and sharing photos of my bad 1988 perm to boot! Well, by replacing my right knee and thereby straightening that leg, it is once again too long – almost 2.5cm. If I don’t address this, it will be difficult to get off crutches and I will start to cause the same problem that led to my knee replacement where my leg bends inwards to compensate for itself and causes abnormal wear.
And so last week I was back with the podiatrist to analyse my gait and figure out the combination of external and internal raise I’m going to need. This morning I posted a shiny new left trail shoe to have an external raise added – 13mm at the rear gradated down to 4mm at the toe. Once that arrives back my podiatrist can re-asses the inner orthotics which are also designed to manage my foot position, size difference and the hyper-mobility I have in other joints.
It’s amazing what modern healthcare professionals can achieve isn’t it? Not just in surgery but with a holistic approach to our biomechanics.
Meanwhile I continue to swim 4x a week and walk locally on my crutches, and I’m amazed how many miles I have clocked up on my Virtual Pennine Way challenge. Since I re-started, post-surgery, I have walked a staggering 62 miles on my crutches. Which means there are just 6 miles left to go to finally complete the full challenge I had to abandon last year.
Thank you to everyone who has cheered, liked, supported and donated along the way – see you soon at the finish line. Love Jill xx
Jill Pringle was born in Sheffield with bilateral hip-dysplasia. She has had several surgeries including open reductions, leg lengthening, hip and knee replacements. Her blog raises awareness of living and walking with the condition and her walking to raise money for Steps Charity Worldwide to which you can donate here.
