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Proximal focal femoral deficiency (PFFD): management options and controversies

D E Westberry1, J R Davids

  • 1Shriners Hospitals For Children: Greenville, 950 West Faris Road, Greenville, SC 29605, USA. dwestberry@shrinenet.org

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|March 24, 2009
PubMed

Insights

Proximal focal femoral deficiency (PFFD) is a congenital hip anomaly with varied severity. Management for PFFD requires individualized treatment, focusing on hip and knee stability before considering limb lengthening or reconstructive surgery.

Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Congenital Anomalies

Background:

  • Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly.
  • It involves the underdevelopment of the proximal femur and hip joint.
  • PFFD presents with significant variability in clinical presentation and deficiency degree.

Purpose of the Study:

  • To outline current management strategies for PFFD.
  • To emphasize the individualized approach required for PFFD treatment.
  • To discuss surgical and non-surgical options based on PFFD severity.

Main Methods:

  • Review of current literature and clinical practices for PFFD.
  • Analysis of treatment strategies based on the degree of femoral shortening.
  • Evaluation of hip and knee joint status in PFFD management.

Main Results:

  • Management strategies are dictated by femoral shortening and hip/knee joint status.
  • Mild PFFD cases may benefit from reconstruction with pelvic and femoral osteotomies.
  • Achieving hip and knee stability is crucial before limb lengthening.

Conclusions:

  • Individualized treatment is essential for acetabular deficiency and proximal femoral deformity in PFFD.
  • Severe PFFD cases may require rotationplasty or amputation for prosthetic fitting.
  • Treatment decisions must prioritize functional ambulation and joint stability.

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