PROXIMAL FEMORAL FOCAL DEFICIENCY - RESULTS OF ROTATIONPLASTY AND SYME AMPUTATION

We reviewed the results of treatment of sixteen patients who had had a n isolated unilateral proximal femoral focal deficiency: nine were man aged with a rotationplasty and seven, with a Syme amputation combined with an arthrodesis of the knee, We evaluated the perceived physical a ppearance, gross motor function, and metabolic energy expended in walk ing, The mean duration of follow-up was 9.9 years (range, four to four teen years), The mean age of the patients at the time of the study was 13.9 years (range, eight to 18.4 years) ill the rotationplasty group and 14.8 years (range, 9.5 to 19.9 years) in the Syme-amputation group , There were three female patients in each group. Roentgenograms showe d that the femoral head was in the acetabulum (Aitken class A or B) in four of the seven patients in the Syne-amputation group and in five o f the nine patients in the rotationplasty group; the remaining patient s did not have this finding (Aitken class C or D). There was no differ ence in gross motor function or perceived physical appearance between the groups, Rotationplasty was associated with a more energy-efficient gait (mean, 0.153 milliliter of oxygen per kilogram-meter [range, 0.1 28 to 0.173 milliliter of oxygen per kilogram-meter]) than was Syme am putation (mean, 0.169 milliliter of oxygen per kilogram-meter [range, 0.151 to 0.182 milliliter of oxygen per kilogram-meter]). Both types o f treatment resulted in a net oxygen utilization per distance (efficie ncy) that was less than the values reported after amputations performe d for non-congenital disorders.