Rotationplasty procedure

Rotationplasty is surgical intervention performed especially on children suffering from a malignant tumour of the femur or a proximal femoral focal deficiency (PFFD). The lower limb’s proximal part is removed and the remaining distal part is rotated 180° and reattached. Then the ankle joint functions as the knee joint. The aim of the study was to present the possibilities of rotationplasty surgery in the reconstruction of the lower limb, as well as its techniques and solutions. Rotationplasty enabled a patient to reach a satisfying functional status.

Unilateral Isolated Proximal Femoral Focal Deficiency in an Egyptian Infant and Review of Literature

Proximal femoral focal deficiency (PFFD) is a rare congenital anomaly of the femur ranging from mild shortening to total agenesis. If left untreated, it could lead to impaired child growth, abnormal gait, vertebral abnormalities, cosmetic problems, and behavioral changes. We report on an Egyptian female, presenting to us at the age of 15 days with a short left lower limb. Both upper limbs and the right lower limb were normal and she was not dysmorphic. The skeletal survey showed an isolated short left femur. At the age of 11 months, clinical reexamination confirmed left femur shortening. Echocardiogram and abdominal sonography revealed no abnormality. Magnetic resonance imaging (MRI) of the pelvis and lower limbs revealed isolated left proximal femoral focal deficiency. Her developmental milestones were normal. She was referred to pediatric orthopaedics for early intervention and proper management. To our knowledge and after reviewing the literature, this patient represents the first case of unilateral isolated proximal focal femoral deficiency in Egypt. In conclusion, PFFD diagnosis needs a systemic skeletal–facial–genital phenotyping to differentiate from overlapping genetic disorders. Early diagnosis and radioimaging are highly important for proper management.