Congenital Short Femur (PFFD)

This 3-year-old boy had a 4-in leg length difference from congenital shortening. Shown before, during, and after right femoral lengthening with the Ilizarov apparatus. The osteotomy (bone cut) in the upper femur was used to derotate the leg to correct the rotational orientation. The lower bone cut was used for lengthening.

Congenital Short Femur with Severe Deformity

A. Standing anteroposterior view radiograph of a 2-year-old boy with Paley type 1 congenital femoral deficiency (limb length discrepancy = 7 cm) and coxa vara. The neck shaft angle = 95° relative to the proximal shaft of the femur. The proximal femoral physis is relatively horizontally inclined. There is a diaphyseal varus of 20°.	B. Treatment by proximal femoral valgus external rotation osteotomy. The proximal coxa vara was not corrected, but the diaphyseal varus was corrected. The lengthening is performed through a distal femoral osteotomy. The lengthening is being performed with an Ilizarov apparatus. The external fixation extends to the tibia, with hinges to allow for knee motion.	C. Final standing anteroposterior view radiographs obtained after limb lengthening (7 cm).
D. Clinical photographs obtained when the patient was 7 years old. He underwent growth stimulation after lengthening and had a 1.5-cm leg length discrepancy at age 7 years. E. Clinical photograph shows maximum knee flexion at age 7 years.

The International Center for Limb Lengthening
Sinai Hospital of Baltimore
2401 West Belvedere Avenue
Baltimore, Maryland 21215, USA
phone: 410-601-8700
toll-free: 800-221-8425
fax: 410-601-9576