Proximal femoral focal deficiency (PFFD) is a rare congenital anomaly of the femur. Rotationplasty has been described as a reconstructive procedure in the management of PFFD. A 68-year-old woman with PFFD of the right leg and rotationplasty at the age of 12 years had prosthetic fitting problems after a fall. The authors describe the analysis of the prosthetic fitting problems and the considerations made in prosthetic management. Following a fall, 56 years after rotationplasty, this woman has a good prosthetic fitting and a satisfying level of functioning.