Restricted growth (dwarfism)

Treating restricted growth

Human growth hormone can help stimulate growth in children with a growth hormone deficiency.

This and other available treatments for short stature are outlined below.

Growth hormone treatment

The National Institute for Health and Clinical Excellence (NICE) recommends a human growth hormone treatment called somatropin as an option for children whose growth failure is associated with any of the following conditions:

  • growth hormone deficiency
  • Turner syndrome  
  • Prader-Willi syndrome 
  • chronic kidney disease 
  • children who are born small and fail to catch up in growth by the age of four or later
  • children with a particular faulty gene, known as short stature homeobox-containing gene deficiency (or SHOX gene haploinsufficiency)

For example, growth hormone is given to girls with Turner syndrome as soon as it becomes obvious that they are not growing normally. This helps prevent short stature during adulthood.

Somatropin treatment should always be started and monitored by a child health specialist (paediatrician) with expertise in managing growth hormone disorders in children. It is usually given as a single daily dose by injection.

Skin reactions are the most commonly reported side effect of somatropin. In rare cases, the treatment is associated with persistent severe headaches, vomiting and vision problems.

For more information, read the 2010 NICE guidelines on Human growth hormone (somatropin) for the treatment of growth failure in children.

Controlling long-term conditions

Controlling long-term conditions, such as lung disease, heart disease or arthritis, from an early stage can reduce the effect these conditions have on growth.

Children should have regular check-ups with their health team and should be referred to a child health specialist (paediatrician) as early as possible. Their care is likely to involve a team of healthcare professionals, including one or more of the following:

  • physiotherapists
  • occupational therapists
  • hearing specialists (audiologists)
  • speech and language therapists
  • specialists in nervous system disorders (neurologists)
  • specialists in spine and joint problems (orthopaedic specialists)
  • geneticists

Leg lengthening

If a person has particularly short legs, a leg-lengthening process, known as distraction, is an option. This involves breaking the leg bone and fixing it to a special frame. This is gradually adjusted every day to lengthen the bone.

However, this can be a long procedure and has a risk of complications. Also, it may not always have the desired results. As there is uncertainty about the safety and effectiveness of distraction in lengthening the leg bone, it is important to understand exactly what the procedure involves and to talk to your doctor about the risks.

Some people have pain after the limb-lengthening procedure. Other possible complications include:

  • poor bone formation
  • infection
  • bone lengthening at an inappropriate rate
  • a blood clot in a vein 

For more information, read the 2006 NICE guidelines on distraction for lower limb lengthening or the NHS leaflet on limb lengthening (PDF, 526Kb).

Last updated: 18 July 2012