Proximal femoral focal deficiency: evaluation and management

Proximal femoral focal deficiency is a rare congenital anomaly characterized by limb malrotation, deficiency of the iliofemoral articulation, and limb length discrepancy. Advances in radiology, such as computed tomography and magnetic resonance imaging, have enhanced the assessment of pelvic-femoral instability prior to ossification of the femoral capital epiphysis. The histopathology of the fetal proximal femoral growth plate has been described, which has increased our knowledge about the etiology of the proximal femoral malformation. Data are now available regarding the long-term functional status of patients with severe acetabular dysplasia (Aitken Class C or Class D deformity) following nonoperative management of the hip. A review of the current knowledge regarding proximal femoral focal deficiency is presented to assist the orthopedic surgeon in evaluation and management.