Module 41, Pediatric Orthopaedist Level

This child was 6 months old when she was referred for a second opinion on her lower extremity deformity. She was the product of a normal pregnancy and delivery. Considerable shortening of the left lower extremity was noted with abnormal musculature about the hip and a marked laxity about the knee joint. The left foot showed valgus deformity and had only four toes.

Question 41A

If an acetabulum is seen on x-ray, the femoral head will also be present although ossification may be severely delayed.

Question 41B

If the foot is at the level of the knee the treatment of choice is a Syme amputation of the foot.

Question 41C

Renal abnormalities are the most commonly associated congenital deformities with Proximal Femoral Focal Deficiency(PFFD).

Question 41D

Foot deformities are very commonly associated with PFFD.

Question 41E

The two essential factors to be considered in determining any treatment plan for PFFD are the predicted length of the femur at maturity and pelvic-femoral stability.