Aitken divided patients with a congenital deficiency of the proximal femur into 4 groups.
|
Class A |
Class B |
Class C |
Class D |
head of the femur |
present and ossified |
present and ossified |
present but not ossified |
absent |
acetabulum |
adequate |
adequate |
dysplastic |
absent |
femoral segment |
very short |
short and deformed |
short and deformed |
short and deformed |
other |
see below |
bony tuft at proximal end of femoral shaft |
bony tuft at proximal end of femoral shaft |
no bony tuft |
In class A the connection between the femoral shaft and the head-neck-trochanter may or may not be ossified. Often there is a pseudoarthrosis at this point with varus deformity.
In class B and C there is no osseous connection between the femoral head and the femoral shaft at skeletal maturity.
Children with a congenital proximal femoral deficiency usually have:
(1) inequality of limb length
(2) malrotation
(3) inadequacy of proximal musculature
(4) instability of proximal joints
Specialty: Surgery, orthopedic, Genetics, Pedatrics
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