Proximal femoral focal deficiency - class A

Discussion:

This boy has marked abnormality of the femur consisting of an abnormally shaped proximal femur with a mid-shaft pseudoarthrosis. Features are consistent with a proximal focal femoral deficiency (PFFD).

In addition of frontal full length x-ray there appears to be absence of  fibula (fibular hemimelia) which is a well recognized association. In fact the fibula is hidden behind the tibia. 

PFFD can be classified in many different ways, but the most commonly used (and simplest) classification is that proposed by Aitken and modified by Amstutz - see classification of PFFD.

According to the Aitken classification this is a class A deformity (type 2 Amstutz). 

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