A case report on surgical excision of intracapsular osteochondroma of femur neck using medial approach without hip dislocation in a young male

Abstract

Osteochondromas also called exostosis are commonest benign bone tumours. Traditionally Osteochondroma are considered as developmental malformations rather than true neoplasms and are thought to formed inside the periosteum due to separation of small epiphyseal growth plate cartilage. But recent studies suggested it’s relation with mutation in gene exotoxin 1 so now they are considered as true neoplasm. The lesions consist of a bony mass produced by progressive endochondral ossification of a growing cartilaginous cap. Most lesions are found during the period of rapid skeletal growth. Approximately 90% of patients only have a single lesion. Osteochondromas generally found on the metaphysis of a long bone near the physis like distal femur, proximal humerus, and proximal tibia. Due to risk of AVN after surgical management makes it difficult for excision. Due to close proximity to important neurovascular bundles these lesions can cause symptoms related to compression. Hip impingement is also common in these cases. Recurrence of osteochondromas are rare sometimes seen due to failure to remove the entire cartilaginous cap. A 24-year-old male presented with complaints of pain around the right hip and difficulty in walking and running since 2 year. On radiographic examination Right sided neck femur osteochondroma was diagnosed, which was located along the anteroinferior margin of the femur neck. Excision of the lesion was done in supine position using medial approach to hip without dislocation of the femur head. Femur neck osteochondroma should be removed surgically safely without dislocating hip. Osteochondroma must be removed completely with cartilagenous cap to avoid recurrence.