American Research Journal of Orthopedics and Traumatology

Background: The advances in bone lengthening for treatment of moderate congenital femoral deficiency have the advantages of preserving the limb function and decreasing the psychosocial burden on the patients.
Patients and Methods: sixteen patients 10 males and 6 females with unilateral Paley Type 1A unilateral proximal femoral deficiency were treated with distraction osteogenesis bone lengthening. The mean follow up period in this prospective study was 36 months (range: 30 – 48 months). The Pediatric Orthopaedic Society of North America Pediatric Outcomes Data Collection Instruments (PODCI) score was used for clinical and functional outcome of the patients. The calculation of growth inhibition or stimulation in this study was began just after removal of the external fixator until 2 years after its removal.
Results: The mean length gained at the end of the procedure was 6.5 cm (SD ±3; range, 4 – 8.5 cm). The mean correction of femoral length discrepancy was 105 % (SD ± 45; range, 85% –165%) with overlengthening of 2-4 cm (average 3cm) in 6 patients (37.5 %). Ten patients (62.5 %) reached the equal femoral length in comparison to the normal femur. According to the PODCI score categories surveyed, the standardized and normative scores were accepted.
Conclusion: The surgical technique of femoral lengthening in patients with Paley Type 1A proximal femoral deficiency is a successful and well tolerated technique.