Benign Aggressive Lesions of Femoral Head and Neck: Is Salvage Potential?
Indian J Orthop. 2018 Jan-Feb;52(1):51-57
Authors: Panchwagh Y, Joshi SK, Sancheti PK
Summary
Background: Benign aggressive bone lesions of the femoral head and neck are largely seen in younger adults and warrant therapy for ache, impending fracture or established fracture, and illness clearance. It turns into difficult to deal with them successfully whereas trying salvage of the femoral head and but reaching long run illness management with minimal problems. We describe our approach and expertise in coping with these lesions which may obtain the above-mentioned objectives and may be simply replicated.
Supplies and Strategies: We analyzed 15 circumstances of surgically handled, biopsy-proven benign, domestically aggressive lesions affecting the femoral head and neck in skeletally mature people. All circumstances had been handled with prolonged curettage by anterolateral modified Smith-Petersen method together with tricortical iliac crest bone graft (mixed with fibular graft in some circumstances) reconstruction with or with out appropriate inner fixation.
Outcomes: All, besides one, sufferers had been obtainable for observe up. The age ranged from 18 to 43 years and the observe up ranged between 24 and 124 months (common 78 months). These included aneurysmal bone cysts (9), large cell tumors (four), and fibrous dysplasia (2). The indication was ache (eight), with impending (2) or established pathological neck femur fracture (5). In all circumstances, there was passable therapeutic of lesion and well timed rehabilitation. Nonunion, avascular necrosis or native recurrences weren’t seen. The MSTS practical rating was good or wonderful in all (vary 26-29, common 28).
Conclusion: Benign aggressive lesions affecting femoral head and neck in younger and middle-aged adults pose a therapy problem. A sturdy, lasting reconstruct with acceptable practical end result and minimal recurrence charge may be achieved by salvaging the femoral head and neck utilizing curettage and reconstruction, obviating the necessity for substitute at such an early age.
PMID: 29416170 [PubMed]