investigation

PFFD

DefinitionPFFD

 

Proximal Focal Femoral Deficiency

- congenital malformation

- characterised by failure of normal development of the proximal femur

 

Epidemiology

 

Rare

- 1 in 50 000

 

Bilateral in 15% 

- usually more severe

 

Association

 

Fibular hemimelia in 2/3

ACL deficient

Toe Walking

Epidemiology

 

70% male

70% positive FHx

20% learning difficulties

 

DDx toe walking

 

Early / late onset

Unilateral  / bilateral

 

1.  Habitual

 

Toddlers - child can heel walk

 

2.  Structural

 

Fixed equinus - CTEV / arthrogryposis

Short / tight T Achilles

Space occupying lesion in calf