Congenital Femoral Deficiency: Paley Type 1b and Paley Type 1c

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, Treatment of congenital femoral deficiency, Chapter 28. In: Operative techniques in pediatric orthopaedics, p 177, 2010). The Paley classification system (Fig. 1) is based on the factors that influence lengthening reconstruction of the congenitally short femur. Type 1 has an intact femur with a mobile hip and knee with subtype 1a having normal ossification and type 1b having delayed ossification of the subtrochanteric region and type 1c delayed ossification of the femoral neck (Paley D, Standard SC, Treatment of congenital femoral deficiency, Chapter 28. In: Operative techniques in pediatric orthopaedics, p 177, 2010). This chapter illustrates the staged reconstructive treatment of two patients with Paley type 1b CFD.