Ghoti Santosh, Mahajan Neetin P, Kondewar Pranay, Pande Kartik Prashant, Chaudhari Kunal
Department of Orthopaedics, Grant Government Medical College and JJ Hospital. Mumbai, Maharashtra, India.
J Orthop Case Rep. 2022 Jun;12(6):66-69. doi: 10.13107/jocr.2022.v12.i06.2868.
Osteochondromas are the most common benign bone tumors. They probably are developmental malformations rather than true neoplasms and are thought to originate within the periosteum as small cartilaginous nodules. The lesions consist of a bony mass produced by progressive endochondral ossification of a growing cartilaginous cap. Osteochondromas usually are found on the metaphysis of a long bone near the physis such as distal femur, proximal tibia, and proximal humerus. Surgical treatment for femur neck osteochondroma is difficult due to the high risk of avascular necrosis following excision. These lesions in femur are in close proximity to important neurovascular bundle and can cause symptoms related to their compression. Furthermore, the symptoms related to labral tear and hip impingement are common. Recurrence is rare and is caused by failure to remove the entire cartilaginous cap.
A 25-year-old female presented with the complaints of pain in the right hip and difficulty in walking and running for 1 year. On radiological examination, the right femur neck osteochondroma was diagnosed, it was located along the posteroinferior margin of the femur neck. Surgical removal of the lesion was done in lateral decubitus position using posterolateral approach to hip without dislocation of the femur.
Osteochondroma at femur neck can be safely removed without surgical hip dislocation. It's necessary to remove it completely to avoid recurrence.
骨软骨瘤是最常见的良性骨肿瘤。它们可能是发育畸形而非真正的肿瘤,被认为起源于骨膜内的小软骨结节。病变由生长中的软骨帽通过渐进性软骨内成骨产生的骨质肿块组成。骨软骨瘤通常位于靠近骨骺的长骨干骺端,如股骨远端、胫骨近端和肱骨近端。由于切除后发生缺血性坏死的风险高,股骨颈骨软骨瘤的手术治疗具有挑战性。股骨的这些病变紧邻重要的神经血管束,可导致与其压迫相关的症状。此外,与盂唇撕裂和髋关节撞击相关的症状很常见。复发罕见,是由于未能切除整个软骨帽所致。
一名25岁女性因右髋疼痛、行走和跑步困难1年就诊。经影像学检查,诊断为右股骨颈骨软骨瘤,位于股骨颈后下缘。采用侧卧位,经髋关节后外侧入路,在不脱位股骨的情况下手术切除病变。
股骨颈骨软骨瘤可在不进行髋关节脱位手术的情况下安全切除。有必要将其彻底切除以避免复发。