Introduction: The goal of surgical equalization of leg length discrepancy (LLD) is to improve the quality of life (QOL) of affected individuals by improving function and appearance. While many surgeons utilize a cut off point of 2cm as a treatment guide, little attention has been focused on the effect of LLD on QOL. The purpose is to determine the critical cut off size for the effect of LLD on QOL. Such information may help refine the surgical indications of leg length equalization in these patients.

Methods: QOL and scanogram data were collected from children diagnosed with LLD at our institution. QOL was assessed using the parent short-form of the Child Health Questionnaire (CHQ). QOL scores from this group were compared to normative data. Correlation analyses and independent t-tests were conducted to assess the relationship between size of LLD and QOL.

Results: Our cohort consists of 41 patients (50 observations) with an average LLD of 2.05cm. Compared to norms, LLD patients scored significantly lower on four CHQ domains. Correlation analyses revealed a negative relationship between size of LLD and several psychosocial domains. Independent t-test revealed that children with LLD greater than or equal to 2cm scored significantly (p< 0.05) higher in six domains than children with LLD> 2cm: General Health, Parental Impact-Emotional Scale, Parental Impact-Time Scale, Family Activities, Family Cohesion, Psychosocial Summary Score.

Discussion and conclusion: With increasing LLD, differences in psychosocial health become especially apparent. This study suggests that children with LLD> 2 cm experience perturbations in QOL, supporting the use of this cut off as a guideline for intervention.