Proximal femoral focal deficiency

Area of Science:

• Orthopedics
• Pediatric Radiology
• Congenital Anomalies

Background:

• Proximal femoral focal deficiency (PFFD) is a congenital condition leading to significant leg length discrepancy.
• PFFD is a distinct clinical and radiographic entity often overlooked in medical literature.
• Associated congenital bony anomalies, particularly fibular hypoplasia, are common in PFFD.

Purpose of the Study:

• To evaluate radiographic criteria for assessing PFFD.
• To determine the effectiveness of hip arthrograms and cine radiography in evaluating hip instability in PFFD.
• To highlight the association of PFFD with other congenital anomalies.

Main Methods:

• Retrospective review of 13 patients diagnosed with PFFD.
• Radiographic assessment of deficiency degree using established criteria.
• Utilizing hip arthrograms and cine radiography for evaluating hip instability, especially in infants.

Main Results:

• Radiographs in the first year of life often failed to fully ascertain hip instability.
• Hip arthrograms combined with cine radiography proved effective in identifying unossified femoral heads and assessing hip instability.
• PFFD frequently presented with concurrent congenital anomalies, most commonly ipsilateral absent or hypoplastic fibula.

Conclusions:

• Early radiographic assessment of PFFD may not fully reveal hip instability.
• Advanced imaging techniques like hip arthrograms and cine radiography are crucial for comprehensive PFFD evaluation.
• Recognizing PFFD's association with other anomalies is vital for complete patient management.