Proximal Femoral Focal Deficiency and the llizarov Technique
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In compliance with the graduation requirements for Kalamazoo College, I completed my Senior Individualized Project during the summer of 1999 in the department of rehabilitation services at the Children's Hospital of Michigan in Detroit. During my eight weeks there, I volunteered on Mondays and Fridays. As a biology major looking to complete my masters in physical therapy, I believe my experience was beneficial not only in that it fulfilled the requirements of my SIP, but also offered me a broad perspective of the different facets of physical therapy that I may want to pursue in the future. Besides helping and observing, my main focus for the first two weeks was to come up with a research topic that was both interesting and well cited in scientific literature. One of the patients that piqued my interest was four year old Emily. Emily was born with a congenital short femur, or more specifically, proximal femoral focal deficiency (PFFD). Even more fascinating than the defect was the corrective option that Emily and her family had chosen. Rather than use a prosthesis, they had opted to gradually lengthen Emily's femur and tibia by the llizarov technique. This means that pins and a fixator would be surgically attached to her leg and after cutting through the bone, the two ends of the fixator would be gradually pulled apart so new bone would fill in the gap. The procedure is repeated anywhere from three to four times during childhood and early adolescence to completely even out the two legs. The idea that people with severe leg length discrepancies could eventually walk without a prosthesis, shoe lift or walker was so fascinating to me that I chose PFFD and the Ilizarov technique as the subject of my research.