Abstract
Congenital femoral deficiency (CFD) is a spectrum of severity of femoral deficiency and deformity.
Deficiency implies a lack of integrity, stability, and mobility of the hip and knee joints. Deformity refers to bone malorientation, bone malrotation, and soft tissue contractures of the hip and knee. Both deficiencies and deformities are present at birth, nonprogressive, and of variable degree (Paley D, Standard SC Lengthening reconstruction surgery for congenital femoral deficiency. In: Rozbruch SR, Ilizarov S (eds) Limb lengthening and reconstruction surgery, ch 29. Informa Healthcare, New York, pp 393–428, 2007).
The Paley classification system is based on the factors that influence lengthening reconstruction of the congenitally short femur. Type 2 has a mobile proximal femur pseudarthrosis with a mobile knee. Type 2a has a femoral head mobile in the acetabulum, 2b has a femoral head fused to the acetabulum, and type 2c has absent femoral head and acetabulum.
The SuperHip 2 (SH2) procedure for types 2a and some 2b combines bone and soft tissue reconstruction to reliably achieve union between the upper femur and the femoral head with the creation of a new femoral neck. The treatment for types 2c (absent femoral head) and 2b fused femoral heads that are not candidates for SH2 is a pelvic support osteotomy.
References and Suggested Reading
Herzenberg JE, Branfoot T, Paley D, Violante FH (2010) Femoral nailing to treat fractures after lengthening for congenital femoral deficiency in young children. J Pediatr Orthop B 19(2):150–154
Paley D, Standard SC (2007) Lengthening reconstruction surgery for congenital femoral deficiency. In: Rozbruch SR, Ilizarov S (eds) Limb lengthening and reconstruction surgery, ch 29. Informa Healthcare, New York, pp 393–428
Paley D, Standard SC (2010) Treatment of congenital femoral deficiency. In: Wiesel S (ed) Operative techniques in orthopaedic surgery. Lippincott Williams & Wilkins, Philadelphia, pp 1202–1223
Paley D, Bhave A, Herzenberg JE, Bowen JR (2000) Multiplier method for predicting limb-length discrepancy. J Bone Joint Surg Am 82:1432–1446
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this entry
Cite this entry
Paley, D., Robbins, C.A. (2015). Congenital Femoral Deficiency: Paley Type 2a . In: Rozbruch, S., Hamdy, R. (eds) Limb Lengthening and Reconstruction Surgery Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-02767-8_31-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-02767-8_31-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-3-319-02767-8
eBook Packages: Springer Reference MedicineReference Module Medicine