Early conservative and operative treatment to gain early normal growth in proximal femoral focal deficiency.

: In three children with proximal femoral focal deficiency (PFFD), arthrography of the hip was performed at the respective ages of 9 days, 4 weeks, and 5 weeks. Between the unossified part of the femoral neck and the cartilaginous femoral head, there was moderate flexibility in the first child and lysis with some displacement of the femoral neck and mobility in the other two children. After the children's immobilization in a squatting cast for 3 months, consolidation was achieved and the growth plate developed normally. All three had marked coxa vara and retroversion. The earlier they were treated by valgus osteotomy and rotation to normal anteversion, the earlier normal growth started. Diagnosis at birth and immediate conservative and early operative treatment is therefore indicated in such cases. Only a few centimeters of femoral lengthening is then necessary, and resection of the unossified part of the femoral neck can be avoided.