Congenitally Short Femur



20 - 30 % LLD




Intact femur radiographically +

- foot at contralateral mid-tibial level

- cruciate ligament deficiency

- coxa vara

- hypoplastic lateral femoral condyle with resulting valgus knee

- sclerosed lateral cortex


Amount of femoral shortening is variable patient to patient


Shapiro Type 1 growth disturbance

- i.e. LLD increases with time





Genu valgum

Fat thigh

High riding patella


Foot held externally rotated




Hypoplastic femur

Coxa vara

Lateral sclerosis


2 groups


Simple femur hypoplasia


Femoral hypoplasia with coxa vara




Align early then lengthen in primary school years


1. Realignment may involve


Coxa vara

- proximal femoral valgising osteotomy


Valgus knee

- Supracondylar osteotomy / guided growth 8 plates


2. Lengthen tibia and femur


Caution for dislocated knee

- ACL deficient


3. Contralateral epiphysiodesis