Management of proximal femoral focal deficiency with limited resources in Haiti

Abstract

Individuals with proximal femoral focal deficiency (PFFD) present with a shortened femur. This report highlights the process used to determine prosthetic candidacy, a novel use of the International Committee of the Red Cross (ICRC) prosthetic materials, and subsequent rehabilitation when treating in rural Haiti. An eight-year-old boy with PFFD whose goal was to walk 'normally' presented with a shortened right leg and typical foot/ankle. Concerns regarding ability to safely load the leg were mitigated after finding he could fully load his right limb, control motion, and had no fractures. A unique prosthosis incorporating a donated hinged ankle-foot orthosis, ICRC materials and a SACH foot was fabricated. Physical therapy followed for two weeks, progressing from static weight-bearing and gait training to dynamic balance activities. At discharge, the patient walked independently using the prosthosis and one forearm crutch. Through collaboration and innovation rehabilitation goals can be realized even when presented with limited resources. Clinical relevance Through collaboration and innovation novel prosthetic designs incorporating materials from the International Committee of the Red Cross can be created and rehabilitation goals can be realized even when presented with limited resources.