Perthes’ disease and femoroacetabular impingement in a child with proximal femoral focal deficiency

Abstract

A girl with known proximal femoral focal deficiency presented with Perthes’ disease at 5 years of age. Her treatment involved a Salter osteotomy. This in conjunction with articular incongruence, due to deformity of the femoral head, resulted in mixed type femoroacetabular impingement when she was 10 years old. Surgical hip dislocation and femoral neck osteochondroplasty successfully relieved her symptoms of impingement. This is the first reported case of Perthes’ disease in a patient with proximal femoral focal deficiency. The case highlights the importance of thoroughly investigating pain in patients with proximal femoral focal deficiency, a condition which is normally painless. Timely diagnosis of Perthes’ disease and containment procedures can prevent collapse of the femoral head and the resultant sequelae. Acetabular over-coverage should be avoided in pelvic osteotomy to prevent the development of femoroacetabular impingement.

Avascular Necrosis in the Contralateral Hip in Patients With Congenital Femoral Deficiency: A Report of 3 Cases

“…13 There have been uncommon links to other anomalies and syndromes described in case reports. [14][15][16] In particular, Pun et al 16 report a case of femoroacetabular impingement after Legg-Calve-Perthes in a 5-year-old patient being followed for congenital femoral deficiency. We report 3 patients who, during longitudinal observation and/or treatment of unilateral congenital femoral deficiency, developed avascular necrosis of the hip in the long (normal) leg (Table 1).…”