الفهرس 
Embryology and development of the Femur and hip joint
Inclusion Criteria:Only 14 pages are availabe for public view
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Abstract
Congenital femoral deficiency (CFD) is a rare condition with an incidence of one in 50000 to 200000, mainly occurring as a sporadic condition.1,2,3 Being the result of abnormal development of the limb bud, many variations of this deformity exist, ranging from shortened but relatively normal femur, to an entirely absent femur with abnormal knee and hip.2,4,5 Clinically, the thigh is shortened and bulky, with the proximal femur flexed, abducted and externally rotated.4 CFD is mostly a proximal deficiency, hence, the condition was originally described as proximal femoral focal deficiency. However, some literature reported distal femoral focal efficiency. CFD is associated with fibular deficiency in up to 70-80%, and other congenital limb defects are found in more than 50% of patients. It can be bilateral in 15% of cases. The condition is not only bony in nature, but also involves the surrounding musculature, which is atrophied.5,6,7,8,9,10 Knee instability is an important concern, with various degrees of anteroposterior instability due to hypoplastic or absent cruciate ligaments. Additional knee problems may include hypoplasia of the lateral condyle, flexion deformity, or congenital fusion in sever forms.11,12 Thus, Congenital femoral deficiency (CFD) describes a broader spectrum of longitudinal deficiency inclusive of proximal focal femoral deficiency, lateral distal femoral hypoplasia, knee cruciate ligament deficiency, rotational instability, patellar dislocation, fibular hemimelia, ray absence, and contralateral limb involvement.13 Proper Radiographs including the pelvis, both femora, and both tibiae is needed to evaluate the degree of hip dysplasia, abnormalities of the proximal femur and assessment of the limb length discrepancy (LLD).5,12 MRI is also important to assess cases of delayed ossification visible on Radiographs and evaluate the connection between the femoral head and shaft to determine whether there is cartilaginous connection or frank pseudoarthrosis, which would have an influence on the classification and surgical management.