Jy. Arlaud et al., USE OF A CUSTOM-MADE FEMORAL PROSTHESIS I N THE TREATMENT OF A FEMORAL AGENESIS, International orthopaedics, 20(2), 1996, pp. 111-116
We describe the management of femoral agenesis in a young adult. Follo
wing previous treatment, including limb lengthening by the Ilizarov te
chnique, the patient was left with 30 cm of shortening, a hip fused in
abduction and external rotation, an ankylosed knee and an ankle which
had been surgically fused. We decided to create a mono-segmental stum
p, based on a mobile hip, in order to accommodate a suitable prosthesi
s. Replacement arthroplasty of the hip was first undertaken using a fe
moral component with a long stem which crossed the knee into the upper
tibia. This allowed correction of the rotational deformity and fusion
of the knee in an appropriate position. Amputation above the ankle wa
s then carried out under the same anaesthetic. A suction prosthesis wa
s attached to the stump. The arthrodesis of the hip was the principle
factor in deciding on this procedure rather than a Van Ness operation
or further lengthening. The result at 3 years is satisfactory and the
patient has good mobility.