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Proximal Femoral Focal Deficiency

A development defect of the proximal femur recognizable at birth in which the femur is shorter than normal and there is apparent discontinuity between the femoral neck and shaft.PFFD consists of a partial skeletal defect in the proximal femur with a variably unstable hip joint, shortening.. Defin

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Proximal Femoral Focal Deficiency

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    1. Proximal Femoral Focal Deficiency By Mustafa Abbas . TMO Orthopaedic and Trauma Unit KTH

    2. A development defect of the proximal femur recognizable at birth in which the femur is shorter than normal and there is apparent discontinuity between the femoral neck and shaft. PFFD consists of a partial skeletal defect in the proximal femur with a variably unstable hip joint, shortening. Defination

    3. Unknown cause – majority of cases Definite cause Anoxia Irradiation Ischaemia Bacterial and viral infection Toxins and hormones Thalidomide Etiology

    4. Sclerotome subtraction theory-- injury to neural crest cells Boden’s theory -- a defect in proliferation and maturation of chondrocytes in the proximal growth plate Theories

    5. 3rd most common longitudinal deficiency of lower extremity bilateral involvement is seen in 15% one per 50,000 live births Maternal diabetes has been implicated in femoral hypoplasia Incidence

    6. fibular hemimelia 70-80% agenesis of cruciate ligaments of the knee clubfoot congenital heart anomalies spinal dysplasia facial dysplasias Associated Anamolies

    7. Short thigh Hip is held in flexion, abduction, and external rotation Position and stability of the knee and foot are variable. Clinical Findings

    8. Limb length inequality proximal joint instability Malrotation weakness of the proximal musculature Primary clinical problems

    9. Aitken's four-part classification scheme Gillespie & Torode classification Nine Pappas Classes of Congenital Abnormalities of the Femur Hamanishi classification Classification

    10. most widely used classification divides PFFD into 4 categories based on the radiographic appearance Aitken's four-part classification scheme

    11. Aitken classification

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