[Solitary proximal end of femur osteochondroma. An indication and result of the en bloc resection without hip luxation].

OBJECTIVE

To review the indication of surgical treatment of solitary proximal end of femur osteochondromas, and present our experience as regards the approach for a complete and safe resection.

MATERIAL AND METHOD: A retrospective study of a series of 6 symptomatic solitary proximal end of femur osteochondromas treated by en bloc resection by means of a single anterior or posterior-lateral approach. The patients were followed up routinely, as well as contacted by telephone to find out their current status. The functional assessment was made using the Musculoskeletal Tumour Society (MSTS) scale. The main limitation of the study was the its low level of recommendation.

RESULTS

There were no post-operative complications and, after a mean follow of 8 years (rang:2-21 years), the clinical result was excellent or good in all cases, and there were no recurrences of the tumour.

DISCUSSION: Although some authors have proposed femur head subluxation or luxation to expose the whole of the femur neck and head to facilitate the resection of the osteochondroma and the joint exploration, in our experience, this can be avoided in the majority of cases.

CONCLUSIONS

Surgical treatment of solitary proximal end of femur osteochondromas is mandatory, as is the detailed pre-operative study of each case. Depending on their implantation and extension, en bloc resection can be performed by a single wide approach without the need for hip luxation.