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Congenital Short Femur

Occurs when the thigh bone (femur) fails to grow correctly in utero, resulting in a limb length difference.

Understanding Congenital Short Femur

Congenital Short Femur, also known as Congenital Femoral Deficiency (CFD) occurs when the thigh bone (femur) fails to grow correctly in utero, resulting in a limb length difference.

In addition to a short femur, babies may also have hip and knee instability and malformation. In most cases, only one limb is affected but the condition can occur in both legs. As the child matures, the limb length difference between the two limbs will continue to increase.


Congenital Short Femur occurs in roughly 1 in 40,000 births and is not considered to be inherited from a relative. The cause of CFD is mostly unknown and varies from mild to severe.


There is no single treatment and options are centered on the degree of involvement with the focus on restoring mobility. Management may include surgical limb lengthening procedures, prosthetic/orthotic intervention, or a combination of the two. 

Shoe lifts, orthoses (braces), and prostheses (artificial limbs) can be used to treat the limb length discrepancy. Generally, the treatment is based upon the amount of the leg length difference.

  • Mild cases in toddlers of a few centimeters are fit with an external lift on their shoe when they begin pulling up to stand and walk.
  • Moderate cases can use a plastic leg brace – ankle-foot orthosis (AFO) – to assist in stabilizing the ankle joint along with a lift to even the leg lengths. 
  • In severe cases, where the leg length discrepancy is over 4 inches (10cm), a “prosthosis” can be fabricated. This usually consists of a prosthetic foot mounted to the bottom of a brace to eliminate the need for a shoe lift.  

Surgical options consist of a series of limb lengthening procedures and should be performed at specialized centers with surgeons who treat many patients with this condition. In the event that the child is not a candidate for a limb lengthening procedure, the surgeon may recommend other surgeries or treatment options.

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