Moderate to severe PAD is characterized as partially to almost fully blocked arteries. In adults, functional LLD can result from chronic pain or arthritis and associated problems in the spine, hip, or knee. Confirm by entering the code sent to your phone on file. Ask a friend or family member to place the palms of their hands on the person's hip bones, so that they have one . You symptoms are that of vascular disease. In general, one of the main reasons why one leg is more sore than the other after exercise is because of the bilateral muscular imbalance. To perform a home test, the person should: Ankles that are not aligned could indicate LLD. Wounds that take a long time to heal or don't heal at all. Give us a call at 888-773-2193 or contact us conveniently online to learn more about our vascular specialists, locations near you, as well as treatment information. Ask the helper to move the persons hips gently from side to side for approximately 60 seconds. All rights reserved. The tests may include examination of the spinal cord and its nerves by magnetic resonance imaging and, if necessary, electrical tests to determine whether the nerves conveying commands from the brain to the muscles in the lower limbs are functioning satisfactorily. Her . Orthopedic Surgery 30 years experience. What are the chances of recovery from traumatic brain injury? Cold feets are not always pathological. How Viagra became a new 'tool' for young men, The amazing story of hepatitis C, from discovery to cure, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.hindawi.com/journals/jhe/2018/7815451/, https://www.hindawi.com/journals/abb/2018/5156348/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551003/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376249/, http://orthokids.org/Condition/Leg-Length-Discrepancy, http://www.childrenshospital.org/conditions-and-treatments/conditions/l/leg-length-discrepancy, https://orthoinfo.aaos.org/en/diseases--conditions/limb-length-discrepancy/. Minor discrepancies often cause no symptoms or problems. Bow legs frequently occur in children and resolve by, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. discomfort is more outside leg? When comparing one leg to the other, you'll notice that one is cooler than . The American Academy of Orthopaedic Surgeons reports that people with a difference in leg length greater than 3.5 to 4 percent may be left with a limp while they walk. Since then, he has noticed one of his legs sometimes gets colder than the other one. Living with uncomfortable symptoms like one leg being cool to the touch or numbness can limit your activity level and lead to a sedentary lifestyle. I discussed it with my dr and he express surprise but offered no solutions. 2022 All Rights Reserved. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Dont wait for your cold or numb legs to worsen; take the first step towards a healthier, more active life today. The te Dr. Tony Willson and another doctor agree. However, one reason you may be experiencing numbness in one leg (whether it be your left or right) is due to a partially or fully blocked artery. If the discrepancy is very small, there may not be any other symptoms. However, moderate-to-severe asymmetry may cause issues with walking and posture, and it can contribute to hip and back pain. You might notice one of your legs suddenly got bigger. Correcting structural LLD is less straightforward. Re: One Leg Colder Than The Other. I do believe that to ignore it would be your best option. It is also important to correct poor posture. A knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface the knee. Please call us us to continue scheduling your appointment. Abstract. Ask a friend or family member to place the palms of their hands on the persons hip bones, so that they have one hand on each hip. You wonder what causes your leg to go numb like this and if it could indicate something serious. Leg lengthening or shortening involves a variety of surgical procedures used to correct legs of unequal lengths, a condition referred to as limb length discrepancy (LLD). A common warning sign of moderate to severe PAD is chronic numbness, tingling, or coolness in . Ask the helper to check the alignment of the persons ankle bones. About eight months after the surgery, she noticed her left leg was 3 inches shorter that her right one. Hi! Recently I have noticed that one of my legs is appearing thinner than the other. Lymphedema symptoms can range from mild to severe. They will also need extensive rehabilitation that includes exercise and physical therapy. When comparing one leg to the other, you'll notice that one is cooler than the other. Khamis, S., & Carmeli, E. (2017). Required fields are marked *. The highest order of preponderance for "coldness" was related to the group of patients whose symptoms . However, a 2017 study notes that a discrepancy as small as 2 centimeters (cm) can cause the pelvis to compensate for imbalances in posture. Many people with leg numbness leave slow or non-healing wounds untreated because they cant feel that they have them. . If youve noticed one of your legs is colder than the other and you are experiencing other PAD symptoms, you need to see a vascular specialist immediately. Is it normal for one side of the body to be thinner than the other? The cause needs study. It's hard to say from your description what exactly is happening to you. islandantoinett renee01952. Posted 7 years ago, 8 users are following. My legs feel heavy and warm and sometimes the bones itself very cold? Well, a knee replacement surgery there's often a correction of a curvature or angle of the leg. LLD occurs because a leg bone grows more slowly in one leg than on the other leg. These types have different causes. Being in one position without moving at all can slow the blood flow,But if feet or a foot is cold, blue, or pulseless, the. Why is one foot colder than the other? Cold Feet !!! Diabetes Diets: Can Diabetics Eat Sweet Potato In Winter Season? When circulation is optimal, healing is optimal. Try Ayurveda And Don't Ignore It, Nutritionist Lovneet Batra Outlines The Many Health Benefits Of Ginger, Building Immunity In Winter With The Goodness Of Herbs, Skincare Tips: Get Glowing Skin This Festive Season With These Ayurvedic Tips. You may experience a variety of peripheral artery disease symptoms if your legs and feet aren't getting enough blood flow to operate correctly. My husband had fusion of L4, L5 & S1 on December 10, 2004 with instrumentation (erector set). leg feels warmer than other one. In some cases, exercise can contribute to functional LLD. Can you please advise me on what I should do and what is wrong with me? Between 8 to 12 million people living in the U.S. have a serious vascular disease known as peripheral artery disease (PAD). Surgical treatment is indicated for discrepancies exceeding 1 in (2.5 cm). Do not copy or redistribute in any form! My left leg below the knee, on the left side keeps going cold.even when i rub it or cover it with blankets it doesn't get warm. Sciatica, which is an irritation of a nerve in the back, is one of the more common causes. For these, please consult a doctor (virtually or in person). : Up to a quarter of people will have a change in the length of the leg after hip replacement surgery. There are many potential causes. dvt will usually have swelling and warm extremity. Afternoon hipsterz! Surgery may be necessary to treat more significant LLDs. My right arm, hip, leg & foot are thinner than the left. Deep vein thrombosis can result in a hot calf although we would also usually see swelling and redness of the leg. If you are suffering from either of those conditions, you should hire a medical . My leg, the operated one, from knee down to my foot get cold. Especially when I'm a sitting. We avoid using tertiary references. Most often, subtle leg length discrepancies are well tolerated and people can adapt to these differences. While waiting for an appointment, a person could try the following home test to see whether there is a possibility of LLD. Additionally, having a numbing sensation in your leg can be dangerous as it can lead to injury. In functional LLD, the leg bones are equal in length. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Hard to say: There are many potential causes. Save my name, email, and website in this browser for the next time I comment. MNT is the registered trade mark of Healthline Media. I keep getting a random weird warm sensation in my ankle and/or leg with no pain and its just the one spot . Ruptured tendons can cause one leg swelling around the location of the injury. I used to have back ache earlier whenever I lifted something heavy or worked too much but I have taken all precations to avoid pain by following all your tips on how to lift things. Are you a Vegan. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Yes you need to make sure the circulation is okay, if it is so, some people are prone to have vasospasm someti Have one cold foot, warms when stood up but cools when sitting, could this be a deep vein thrombosis? A: The fact that one of your legs is slimmer than the other suggests that the muscles in that leg may be wasting away. One of my legs and foot is colder than the other by touch. This is common in people who have long journeys or recently had surgery. If you cant feel your leg, you may not realize youve been injured or that you have an open wound. One or both of your legs/feet are heavy. Let us know how he fares-. My legs get so cold that i can't stand it. Expert Answers, Weight Loss Tips: 8 Mini Meals To Choose From, When You're Trying To Lose Weight According To Nutritionist Anjali Mukerjee, Best Strong Legal Stimulants And Energy Pills Like Speed, Experiencing Irregular Or Delayed Periods? A Increase font size. Take our PAD Risk Assessment now: TAKE THE QUIZ. Answer (1 of 4): Some people have cool extremities simply because the OR is cool and they may be a bit hypothermic if the procedure is long and no warming blankets were used. | Hip Replacement | Forums | Patient. Sciatica, which is an irritation of a nerve in the back, is one of the more common causes. After you receive a clear diagnosis, our experienced physicians will work with you to choose a treatment plan that fits your individual needs. This really should be checked out. Skip the wait times! The differences in leg length can range from a fraction of an inch to several inches. There's excess liquid between cells and pressure on cells and blood vessels alike. Your email address will not be published. Heaviness in one or both of your legs/feet, Cramping in your buttocks, thigh, calf, or feet, Coolness felt in one leg compared to the other. My foot swells some and even is a lil darker in color than my other foot. This could very likely be related to peripheral vascular disease or pvd. I had to have a L4-L5 fusion in Feb. 2003. Muscle imbalance means the muscles in the dominant leg are more active during certain exercises, compared to muscles in the weaker leg. You go to massage the feeling back and find that your one leg is colder than the other. If an athlete trains in a way that causes muscle imbalances or weaknesses, they may temporarily experience functional LLD. Please ensure email address is accurate as all important information regarding treatment, schedules will be sent here. Neuromuscular conditions are another potential cause of functional LLD, as these conditions can affect a persons alignment and posture. The muscles around the new hip are not working properly and are not holding your pelvis up therefore, you may still notice a limp or a sag to the operative side. Sitemap | Privacy Policy | HIPAA Privacy A Reset font size. I am going to a specialist on the 4th and that is one of the questions I have on my list of things I need to know about. Some potential treatment options include: A person who has mild LLD of less than 1 inch may benefit from wearing a shoe lift inside the shoe on the shorter leg. However, one leg appears longer than the other due to an issue with one of the following body parts: In children, functional LLD can occur when a child is born with an issue that alters their hip alignment. The one in the back of my operated leg was the size of a FOOTBALL. She joined the orthopedic surgery staff at Mayo Clinic in Jacksonville, Florida in 1991, and since 2005 has served as department chair. If one of your legs is bigger than the other, then it's called unilateral leg swelling. Fatigue after surgery is a common complication and an expected one. An error occurred while processing your information. One or both of your legs/feet are heavy. This swelling can also develop over time. There are two types of LLD: functional and structural. This curvature often involves both knees. A thermographic study on admission of 174 hospital patients with sciatica revealed a significant correlation between decreased temperature of the distal part of the affected limb and the probability of spinal nerve root compression. A new concept for measuring leg length discrepancy. The condition is known as leg length discrepancy. The greater the difference, the more likely it is that the person will experience issues with gait, posture, and pain. Remove their shoes and socks. A doctor can diagnose the condition and recommend appropriate treatments. my legs become swollen and warm to touch. Why do I get cuts on my frenulum during intercourse? This can be due to deep vein thrombosis, muscle tear, cellulitis, ruptured Baker's cyst, compartment syndrome, etc. You are obviously taking empty calories in the shape of sweet "goodies". The cause needs study. A common warning sign of moderate to severe PAD is chronic numbness, tingling, or coolness in one or both of your legs. When I had back pain a few days back, I showed to a doctor in Punjab who had helped me earlier. Northbrook IL-60062 Talk to a doctor now . To avoid causing further issues, it may be sensible to seek the help of a physical therapist. An uneven leg length can occur when the knee that's been replaced . It can also lead to a hip that has poor rotational control. observation of how the person stands, sits, and moves, measuring the LLD by asking the person to stand on blocks of various heights until the hips are level. 2004-2022 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. Scheduling at your fingertips, 24/7. will i have problems this winter too? People should see a doctor if they suspect that they or their child has LLD. All rights reserved. def have him to go the dr. Why am I suffering from calcified brain lesion? This actually occurs because of the tilt of your pelvis after surgery. He advised that I need hospital admission for a week so that they can pull some muscles or something. Having one leg longer than the other is relatively common. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. These tests will enable the doctor to determine the cause. Structural LLD occurs when either the thigh bone (femur) or the shin bone (tibia) is shorter in one leg than in the other. After looking at my x-rays, he suggested that since I had fallen down on my buttocks a few months back on the stairs, the gap in my spinal cord has decreased at the bottom of the spinal cord and blood circulation has stopped thereby affecting my leg. Many healthy adults have a small difference in length between their two legs. Yan Katsnelson, M.D., warns that without sufficient blood flow, the tissues in your legs and feet may begin to shut down and die. Definition. It could be either a nerve problem or a circulation problem. Nonsurgical PAD treatments like stent angioplasty or atherectomy can help restore blood flow to your legs eliminating symptoms such as numbness, one leg being cool to the touch compared to the other, and tingling sensations. A shoe lift can alleviate back pain and improve a persons gait. While not common, it's possible to have a leg length discrepancy following this procedure. Some research indicates that 4070% of people have some form of leg length discrepancy (LLD). Many different things can cause sore feet, including injury, pregnancy, and some health conditions. confirm my parent(s) or personal representative consent my intention to have a treatment The therapist can identify areas of imbalance and recommend appropriate exercises. what could casuse this? Doctors typically provide answers within 24 hours. While feeling tired is normal, feeling exhausted is not typical. Dr. Yan has established himself as a strong advocate for accessibility and affordability of the most advanced medical care close to home, and his mission is to create a positive experience for each patient with compassionate, personalized, and expert care. The treatment for functional LLD typically involves physical therapy, massage, and specific exercises to correct areas of imbalance and weakness. In turn, this will help the doctor advise you on the means to prevent further slimming. Leg(s) fading to a light blue or grey hue. A look at supination and pronation of the foot normal functions of the stride. People who suspect that they have one leg longer than the other should see a doctor for a diagnosis. . Advertisement . Tomato Flu: Symptoms, Causes And Everything We Know So Far, Mother's Day 2022: Mothers - A Boon From God, Countries In WHO South-East Asia Region Renew Commitment To Eliminate Malaria By 2030, Elimination Of Lymphatic Filariasis: Here's How Karnataka Health Officials Are Ensuring Lymphatic Filariasis Doesn't Spread, Urgently Address Gaps In Cancer Care: WHO. If the other knee is well, there's less of a chance of perceiving . You try to move it in circles to regain some feeling and it doesnt help. Last medically reviewed on April 30, 2020, Antalgic gait is when leg or foot pain alters the way a person walks. commenced during the night no injury or change in exercise. You can learn more about how we ensure our content is accurate and current by reading our. There are a few explanations you may have felt one leg colder than the other. At its worst, it can cause disfiguration and leave a person susceptible to deadly skin infections. Now I have been having this issue on & off, today really was the worse. 1 doctor answer 2 doctors weighed in. Madonna, I had a fusion at L5 S1 in April 2002 and since then my left foot and lower leg has been cooler than the right. I am a bit apprehensive as is my husband. This article looks at the symptoms, the differences between a sprain and a break, and some, Learn here about bow legs, a condition in which a persons legs appear to bow or bend outward. It looks as though you are already registered. Swelling has a way of congesting circulation locally. Certain diseases can cause these symptoms, like diabe You will need a medical doctor. A Word From Verywell. Between 8 to 12 million people living in the U.S. have a serious vascular disease known as peripheral artery disease (PAD). Naturally, imprecision can cause complications. My husband had fusion of L4, L5, & S1 in December. If your legs feel numb and tingly or one leg is colder than the other, you should seek treatment as soon as you can. Dear Dr. Roach: Four years ago, my wife had hip surgery caused by a fall. As you continue your physical therapy and strengthen the muscles around your . A leg length discrepancy may be functional or structural in nature. Youre sitting in a comfy camping chair at your daughters baseball game cheering her team on when you feel some numbness and tingling in your lower left leg. We also provide information on the diagnosis of LLD and the treatment options available. View Comments. Lower left leg pain. Arthritic conditions can We will start with your personal history. It is my inner chin area. At USA Vascular Centers, our vascular specialists use either an angiogram or ankle-brachial index (ABI) test to determine the severity of your condition. I have legs pain after i wake up from a cold night. It will be necessary to see a doctor to confirm LLD and to determine whether it is a functional or structural issue. A:The fact that one of your legs is slimmer than the other suggests that the muscles in that leg may be wasting away. When your legs and feet arent getting the blood flow they need to function properly, you could feel a number of peripheral artery disease symptoms including: These are only a few of the many signs and symptoms of PAD; you can check out the full list here. For instance, a ruptured Achilles tendon will cause swelling in the lower part of the calf and ankle. In some situations, a more significant leg length discrepancy will not be well tolerated. Lymphedema is most commonly seen in the arms or legs. If you haven't got an answer by then, I will post and let you know what the specialist says about it. By submitting this form you agree to our Privacy Policy. : Dr. Mary O'Connor, M.D., was accepted as a resident in orthopedic surgery at Mayo Clinic in Rochester, New York in 1985. Patients will often hear a loud "popping" sound and feel a sharp pain when the rupture happens. For more information on bones and joints visit http://www.empow. i knew dvt cause warm limbs, can it cause cold? what causes this. This really should be checked out. It could be either a nerve problem or a circulation problem. I started having them too post op, about day 6 or so. To learn more, please visit our. When you touch his leg, it is cooler than the other one. What does it mean when your foot does not stay warm unless you keep a foot warmer on it year around and the rest of the leg starts turning to cold as. As a result, people who do not get PAD treated can be at a significant risk of heart attack, stroke, and gangrene resulting in amputation. Lymphedema is a chronic condition that tends to recur over time. This is why your doctor has advised you to undergo tests. For further assistance, please contact us. A doctor may use several methods to diagnose LLD. Third, and possibly the most common reason leg lengths are unequal after hip surgery, is the need for stability within the replaced joint. However, if you are left with one leg shorter after a fracture, you may need to seek specific treatment. Seeing a physician could help determine if this is the case. . Must be nerve related. He is the Founder and CEO of USA Vascular Centers, which is part of USA Clinics Group, the parent company of USA Fibroid Centers, USA Vein Clinics, and USA Oncology Centers with more than 90 facilities nationwide. Posted 7 years ago. Included is detail on complications, diagnosis, and how to prevent it. It looks like you are an existing patient. Original poster here. Well after tomorrow I have 2 more weeks of non weight bearing. 304 Wainwright Dr. In this article, we discuss the causes and symptoms of LLD. For example, you may notice that doing 10 reps of bilateral step-ups on . It is what can cause one leg to swell and become larger than the other. However, it is important that people use the correct stretching and strengthening techniques. the only way to warm them is a very hot bath. If you have noticed that both of your legs feel numb and tingly or one foot is cold to the touch, you should consult a vascular specialist as soon as possible. Exercises may help correct some functional LLDs. A broken thumb can cause severe pain and discomfort. 6 The body is stressed by the effects of anesthesia and surgery. 24/7 visits - just $39! PAD occurs when plaque buildup within the arteries blocks blood flow to the legs, thighs, calves, buttocks, ankles, and feet. 50% off with . Q:Hi! Posts: 2,128. Learn more about the causes and remedies here. One leg colder than other. This motion helps loosen up tight muscles. This is why your doctor has advised you to undergo tests. Moderate-to-severe cases of LLD can cause additional symptoms, including: The study authors also note that LLD can affect a persons overall quality of life. There's a drop down list and opportunity to read some very helpful articles on TKR recovery including icing & elevating. That can result in a slightly longer leg length. PAD occurs when plaque buildup within the arteries blocks blood flow to the legs, thighs, calves, buttocks, ankles, and feet. Dr. O'Connor explains whether one leg is longer than the other after hip replacement surgery. I'm 17 and this morning my legs started to randomly hurt. Supplements for heart health: Which ones are beneficial and which ones are not? Treatment typically depends on the difference in length between the legs. The exact type and number of interventions that a person needs will depend on the underlying cause and severity of the LLD. Some potential causes of structural LLD include: The main symptom of LLD is having one leg longer than the other. Dear G.W. There are two common causes of one calf being hotter than the other. This is what's termed acute leg swelling. This can actually be present until the other knee is fixed. Dr. Do you know what causes this? About Dr. O'Connor, M.D. A blockage means that the tissues and muscles in your legs arent getting enough oxygenated blood. Am I getting correct treatment for peripheral neuropathy? These tests will enable the doctor to determine the cause. Leg length discrepancy following total hip replacement surgery is a possible complication of the surgical procedure. I suspect the latter since it is cool to the touch.something may be cutting off the blood supply to the leg and that wouldn't be good. Walking or climbing stairs is difficult. The surgery was successful, but I developed some numbness in my right leg, which I never had before surg. Ruptured Tendon. I suspect the latter since it is cool to the touchsomething may be cutting off the blood supply to the leg and that wouldn't be good. Lie down on the floor, keeping the legs together. After that surgery my right foot had some numbness and was cold. I had an L5-S1 fusion in May 2002. This website follows the DNPA Code of Ethics, --------------------------------Advertisement---------------------------------- -. It may happen because of injury, inflammation, or a range of conditions, such as. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. By using our website, you consent to our use of cookies. Thankfully, diagnosis and treatment for peripheral artery disease is simple as well as convenient. What are the chances of recurrent seizures? As part of hip replacement, the soft tissues surrounding the joint must be stretched to the appropriate tightness to ensure that the joint stays in place. If circulation is compromised that can lead to other problems. They both require a visit to the doctor to rule out. If youve ever experienced leg numbness or one leg colder than the other, youre not alone, says Dr. Yan Katsnelson. Has he talked with his dr about this as it sounds like a circulation problem?? For potential or actual medical emergencies, immediately call 911 or your local emergency service. The surgery was successful, but I developed some numbness in my right leg, which I never had before surg. Do you have any medical issues like diabetes high cholesterol or hypertensi Dr. Andrew Seibert and another doctor agree. Lie down on the floor, keeping the legs together. Orthopedic Surgery 30 years experience. I'm under the age of 18 years old and I Sms code was sent to this phone number [phone], Your email address will not be published. Hypertension: Can 15 minutes of yoga a day help control blood pressure? My leg is warm to touch but feels cold as if i have no blood going to my foot? When one of the knees is straightened it actually does make the leg longer. Having one leg longer than the other is a relatively common occurrence. 6. I'm not sure that's what your wife had, but that's a common surgery after a . They should also take care to exercise the side of the body that will help correct the LLD. Getting up to stretch, you realize your legs feel achy and tired as well. Dr. Yan Katsnelson is a philanthropist, business owner, and highly skilled cardiac surgeon. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. . Cancer treatment shows promise against multiple sclerosis in mouse study, Alzheimer's: Blood test may detect 'toxic' protein years before symptoms emerge, Low levels of vitamin D in the brain linked to increased dementia risk, What to know about supination of the foot. A Decrease font size. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Blocked arteries can lead to heart attack, stroke, and amputation; therefore, you should never ignore PAD symptoms. Several surgical options are available, each of which aims to do one of the following: Following surgery, people will require regular follow-up visits to the doctors office. at USA Vascular Centers. I used to have back ache earlier whenever I lifted something heavy or worked too much but I have taken all precations to avoid pain by following all your tips on how to lift things. The sooner he gets seen the better. seems when it gets cold i have severe hip pain, and hard to keep sitting up? Cramping in the buttocks, thigh, calf, or soles of your feet. The body is working hard to repair the incisions and loss of blood, and feeling tired is a normal part of recovering from surgery. Talent Agents Now Hiring New Faces Paid Kids Acting & Modeling jobs The condition typically presents at birth, but it can also happen as a child grows. It isnt the sensation of one leg being colder, the leg actually feels colder than the other one. In turn, this will help the doctor advise you on the means to prevent further slimming. OH Renee and Jenfid THANK YOU SO MUCH for telling us you TOO had terrible leg cramps. The surgeon may end up using a hip replacement that is not sized correctly which can make one leg longer than the other leading to a lifelong limp and pain.
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