• Disease Overview
  • Synonyms
  • Signs & Symptoms
  • Causes
  • Affected Populations
  • Disorders with Similar Symptoms
  • Standard Therapies
  • Clinical Trials and Studies
  • References
  • Programs & Resources
  • Complete Report

Femoral Facial Syndrome


Last updated: August 18, 2020
Years published: 1993, 2003, 2020


NORD gratefully acknowledges Cyril Boulila, MD Candidate, McGill University School of Medicine and Dr. Malte Spielmann, Max Planck Institute for Molecular Genetics, Berlin, Germany, for assistance in the preparation of this report.

Disease Overview


Femoral facial syndrome is a rare disorder that occurs randomly (sporadically) in the population. There have been, however, two patients reported in which the disorder appeared to be inherited in an autosomal dominant pattern. The major symptoms of this disorder are underdeveloped thigh bones (femoral hypoplasia) and unusual facial features.

  • Next section >
  • < Previous section
  • Next section >


  • femoral dysgenesis, bilateral
  • femoral dysgenesis, bilateral-Robin anomaly
  • femoral hypoplasia-unusual facies syndrome
  • FFS
  • isolated femoral hypoplasia
  • < Previous section
  • Next section >
  • < Previous section
  • Next section >

Signs & Symptoms

Femoral facial syndrome is a rare disorder characterized by underdeveloped thigh bones (femurs) and unusual facial characteristics. It presents with a very broad range and variety of symptoms. One source lists 31 clinical signs, classified as very frequent, relatively frequent and less frequent.

Clinical signs characterized as very frequent are (80-99%):

– Cleft palate
– Femur absent/abnormal
– Unusually small and/or retracted jaw (micrognathia/retrognathia)
– Short limbs (micromelia, femur especially)
– Abnormal vertebral size or shape

Clinical signs characterized as relatively frequent are (20-30%):

– Upwardly slanting eyelids (upslanted fissures)
– Thin lips + Long vertical groove in the middle of the upper lip (philtrum)
– Low-set and poorly formed ears / Small or virtually absent ears (microtia/anotia)
– Fused bones of the spine (sacrum and coccyx)
– Short stature (dwarfism) 
– Hip dysplasia
– Femoral neck anomaly (coxa vara)
– Abnormal fibula morphology
– Deformation of the foot that may be turned outward or inward (talipes-equinovarus)
– Extra toes (preaxial foot polydactyly)
– Maternal diabetes

Clinical signs characterized as less frequent are (5-29%):

– Cross sided eyes (strabismus)
– Sprengel anomaly
– Rib fusion
– Radius and ulna bone fusion (radioulnar synostosis)
– Scoliosis
– Underdeveloped kidneys (renal hypoplasia)
– Kidney function anomaly (polycystic kidney dysplasia)
– Enlarged penis
– Enlarged heart ventricles (ventriculomegaly)

  • < Previous section
  • Next section >
  • < Previous section
  • Next section >


The exact cause of femoral facial syndrome is not known. Most cases of this disorder occur for no apparent reason (sporadically). However, there have been at least two reported cases of affected relatives that are thought to have been inherited as an autosomal dominant pattern.

Dominant genetic disorders occur when only a single copy of a non-working gene is necessary to cause a particular disease. The non-working gene can be inherited from either parent or can be the result of a mutated (changed) gene in the affected individual. The risk of passing the non-working gene from an affected parent to an offspring is 50% for each pregnancy. The risk is the same for males and females.

In addition, a significant number of reported patients seem to show an association with diabetes in the mother during pregnancy.

  • < Previous section
  • Next section >
  • < Previous section
  • Next section >

Affected populations

Femoral facial syndrome is a very rare disorder that seems to affect more males than females. As of 1993, about 55 patients had been reported and one-third of are associated with maternal diabetes.

  • < Previous section
  • Next section >
  • < Previous section
  • Next section >

Standard Therapies

Orthopedic medical care including surgery may help alleviate some of the more serious bone deformities associated with femoral facial syndrome.

Treatment requires the coordinated efforts of a team of specialists. Pediatricians, dental specialists, surgeons, speech pathologists and others may systematically and comprehensively plan the child’s treatment and rehabilitation. Cleft palate may be repaired by surgery or covered by an artificial device (prosthesis) that closes or blocks the opening in the roof of the mouth.

Genetic counseling is recommended for patients and their families. Other treatment is symptomatic and supportive.

  • < Previous section
  • Next section >
  • < Previous section
  • Next section >

Clinical Trials and Studies

Information on current clinical trials is posted on the Internet at https://clinicaltrials.gov/. All studies receiving U.S. Government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Toll-free: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

Some current clinical trials also are posted on the following page on the NORD website:

For information about clinical trials sponsored by private sources, contact:

For information about clinical trials conducted in Europe, contact:

  • < Previous section
  • Next section >
  • < Previous section
  • Next section >


Campbell Jr, RM. NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:712-13. 

Jones KL. Ed. Smith’s Recognizable Patterns of Human Malformation. 5th ed. W. B. Saunders Co., Philadelphia, PA; 1997:310-11.

Buyse ML. Editor-in-Chief. Birth Defects Encyclopedia. Blackwell Scientific Publications. Center for Birth Defects Information Services, Inc., Dover, MA; 1990:681-82.

Luisin M, Chevreau J, Klein C, et al. Prenatal diagnosis of femoral facial syndrome: Three case reports and literature review. Am J Med Genet A. 2017 Nov;173(11):2923-2946. https://www.ncbi.nlm.nih.gov/pubmed/28948695

Spielmann M, Marx S, Barbi G, et al. Femoral facial syndrome associated with a de novo complex chromosome 2q37 rearrangement. Am J Med Genet A. May, 2016; 170A(5):1202-1207. https://www.ncbi.nlm.nih.gov/pubmed/26822876

Femoral-facial syndrome. Orphanet. Last update: July 2009. https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=1988. Accessed August 18, 2020.

Femoral-facial syndrome. OMIM. Updated 01/08/2019. https://omim.org/entry/134780 Accessed August 18, 2020.

  • < Previous section
  • Next section >

Programs & Resources

RareCare® Assistance Programs

NORD strives to open new assistance programs as funding allows. If we don’t have a program for you now, please continue to check back with us.

Additional Assistance Programs

MedicAlert Assistance Program

NORD and MedicAlert Foundation have teamed up on a new program to provide protection to rare disease patients in emergency situations.

Learn more https://rarediseases.org/patient-assistance-programs/medicalert-assistance-program/

Rare Disease Educational Support Program

Ensuring that patients and caregivers are armed with the tools they need to live their best lives while managing their rare condition is a vital part of NORD’s mission.

Learn more https://rarediseases.org/patient-assistance-programs/rare-disease-educational-support/

Rare Caregiver Respite Program

This first-of-its-kind assistance program is designed for caregivers of a child or adult diagnosed with a rare disorder.

Learn more https://rarediseases.org/patient-assistance-programs/caregiver-respite/

Patient Organizations

No patient organizations found related to this disease state.

National Organization for Rare Disorders