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I was just wondering if anyone has been treated by Dr. Paley and not had lengthening? Does he also perform amputations and rotations?

I just sent him an email to confirm what other options he offers. It may depend on what the classificaiton is, but as soon as he replies I will post the answer. He usually uses a blackberry, so his reply may be brief. For the final answer you can contact them directly at 1-800-221-8425. They usually will let you send them a set of xrays for them to review. Let me know what your classification is and what other issues that might be involved, and I will pass them along to him directly. Thanks.


I asked Dr. Paley for an example of his treatment plan for Class D PFFD, and his reply is as follows...

When there is no femoral head and the femur is very short and especially
when the knee is stiff I prefer to do a special time of rotationplasty
I make the knee a hip and the ankle a knee.

Again he is responding via the blackberry portable, so using your thumbs makes it hard to send detailed replies. There are so many different classifications for PFFD, and there are also some side issues like knee instability, hip orientation, and missing bone structure that you really need to get an exact diagnosis from him or his staff by sending in some xrays, or fly out there and get the total workup done. If you have a chance to do that I highly recommend it. Just make sure you plan for a full day there for your consult. Usually existing patients get priorty 1, and then they work down the line. For a new patient it seems long, but once you are in the process you really appreciate having things looked at and dealt with as soon as possible. So fly in the night before, stay for the day, and fly out the next morning, that's what we do even today. Feel free to email us at with any further questions.

Chuck, Karla, Dylan & McKenna