Paediatric orthopaedics: proximal femoral focal deficiency: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric orthopaedics: proximal femoral focal deficiency

Sample item

A newborn has a markedly short right thigh held flexed, abducted and externally rotated. A radiograph shows absence of the proximal femoral segment with a normal acetabulum fully formed on the other side. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Proximal femoral focal deficiency

Proximal femoral focal deficiency is a congenital failure of formation of part of the proximal femur, leaving a short, bulky thigh with an unstable hip and often an associated fibular hemimelia. Management is directed at prosthetic fitting, sometimes after Syme amputation or rotationplasty. Dysplasia of the hip does not remove the femoral segment.

Option by option

  • A. Proximal femoral focal deficiency (correct)

    Correct. A congenitally absent proximal femoral segment with a short thigh is characteristic.

  • B. Congenital coxa vara

    Congenital coxa vara has a reduced neck-shaft angle with a present femoral neck.

  • C. Perthes disease

    Perthes disease occurs at 4 to 8 years from avascular necrosis.

  • D. Developmental dysplasia of the hip

    Developmental dysplasia has a normal femur with a shallow or dislocated hip.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Proximal femoral focal deficiency. Proximal femoral focal deficiency is a congenital failure of formation of part of the proximal femur, leaving a short, bulky thigh with an unstable hip and often an associated fibular hemimelia.

Why is "Congenital coxa vara" not the answer?

Congenital coxa vara has a reduced neck-shaft angle with a present femoral neck.

Why is "Perthes disease" not the answer?

Perthes disease occurs at 4 to 8 years from avascular necrosis.

Why is "Developmental dysplasia of the hip" not the answer?

Developmental dysplasia has a normal femur with a shallow or dislocated hip.

What concept does this question test?

It tests Paediatric orthopaedics: proximal femoral focal deficiency in Orthopaedics. Management is directed at prosthetic fitting, sometimes after Syme amputation or rotationplasty. Dysplasia of the hip does not remove the femoral segment.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric orthopaedics: proximal femoral focal deficiency?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.