A. Standing anteroposterior view radiograph of a 2-year-old boy with Type 1 congenital femoral deficiency (limb length discrepancy = 7 cm) and coxa vara. The neck shaft angle = 95° relative to the proximal shaft of the femur. The proximal femoral physis is relatively horizontally inclined. There is a diaphyseal varus of 20°.
B. Treatment by proximal femoral valgus external rotation osteotomy. The proximal coxa vara was not corrected, but the diaphyseal varus was corrected. The lengthening is performed through a distal femoral osteotomy. The lengthening is being performed with an Ilizarov apparatus. The external fixation extends to the tibia, with hinges to allow for knee motion.
C. Final standing anteroposterior view radiographs obtained after limb lengthening (7 cm).