- How the diagnosis is made
- Classification of congenital short femur
- Treatment of congenital short femur
- What causes congenital short femur
The congenital short femur is a malformation characterized by a decrease in the size or absence of the femur, which is the thigh bone and the largest bone in the body.
This change can be discovered on ultrasound in the 2nd or 3rd trimester of pregnancy and may indicate the presence of a disease such as Down syndrome, dwarfism or achondroplasia, for example, or it can only indicate that the baby has a shortening or absence of the femur, no having no other health problems.
How the diagnosis is made
- During the pregnancy:
The doctor may discover that the baby has a short congenital femur through ultrasound performed during prenatal care, where the size of the femur is measured. The ideal length of the femur during pregnancy should be approximately:
- 24 weeks gestation: 42 mm26 weeks gestation: 48 mm28 weeks gestation: 53 mm30 weeks gestation: 58 mm32 weeks gestation: 60 mm34 weeks gestation: 65 mm36 weeks gestation: 69 mm38 weeks gestation: 72 mm40 weeks gestation period: 74 mm
These measurements are approximate and, therefore, the baby may be growing as expected if it presents lower values than those indicated here and that is why the doctor who is monitoring the pregnancy should indicate whether the baby has a short femur.
Often a small change is found at the end of pregnancy, but the height of the parents and the family must also be taken into account because if the parents are not too tall, their baby should not be too and this does not indicate any health problem.
- After birth:
And in some cases the obstetrician does not observe any significant changes during pregnancy, but the pediatrician may discover that the baby has some change in the length of the femur or the fit of that bone in the hip when performing some tests in the first 3 days that the baby is in the hospital after birth.
Find out what are the tests performed in the maternity ward and the possible changes that the pediatrician can find in: What is Congenital Hip Dysplasia, a condition where the femur is smaller than it should be or there are changes in the fit in the hip.
Classification of congenital short femur
After identifying that the femur is smaller than it should be, the doctor must also observe what type of alteration the baby has, which can be:
The red part of the image indicates the part of the bone that is smaller or missing and therefore indicates:
- Type A: A small part of the femur, under the head of the femur is deficient or absent; Type B: The head of the femur is attached to the lower part of the bone; Type C: The head of the femur and the acetabulum, which is the location of the hip, is also affected; Type D: Most of the femur, acetabulum and part of the hip are absent.
Treatment of congenital short femur
The treatment of the congenital short femur takes a long time and aims to improve the baby's quality of life. When the shortening of the femur is up to 2 cm in length in adulthood, the doctor may decide not to perform any specific treatment, but when the shortening is greater than 5 cm, treatments and surgeries are necessary, which must be performed throughout life but which must be started in childhood.
The doctor can know the length of the femur that the child will have in adulthood using the Paley multiplier method and, according to the result, he can indicate the following treatments:
- For shortening up to 2 cm in adults:
When the shortening of the femur is up to 2cm, the treatment can be compensated for in the footwear of the difference between the legs, through the use of insoles or elevation in the sole of the shoe to prevent scoliosis from developing and pain in the back or other compensations in the feet. muscles and joints.
- For shortening between 2 and 5 cm in adults:
When the shortening of the femur is between 2 and 5 cm, surgery can be performed to cut the bone of the healthy leg so that they are the same size, have surgery for femoral or tibial stretching and while waiting for the ideal moment of the surgery, it can be used only compensation with suitable footwear or prosthetic leg.
- For shortening of more than 20 cm in adults:
When the shortening is greater than 20 cm, which is practically half the normal size in adulthood, it may be necessary to amputate the leg and use a prosthesis or crutches for life. In this case, surgery is the most effective treatment and aims to add prostheses to the bone so that the person continues to walk normally. The surgery should be performed, preferably, before 3 years of age.
In any case, physiotherapy is always indicated to reduce pain, facilitate development and avoid muscle compensations or prepare for surgery, for example, but each case must be analyzed personally because the physiotherapeutic treatment will be different for each person because the needs of one can not be the other's.
What causes congenital short femur
The congenital short femur develops during pregnancy and can be caused by infections caused by viruses, drug use during pregnancy, exposure to radiation or taking some medications such as Thalidomide, for example, but the causes cannot always be clarified.
