Benign Aggressive Lesions of Femoral Head and Neck: Is Salvage Attainable?
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 principally 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 attaining long run illness management with minimal problems. We describe our method and expertise in coping with these lesions which might obtain the above-mentioned objectives and will be simply replicated.
Supplies and Strategies: We analyzed 15 circumstances of surgically handled, biopsy-proven benign, regionally aggressive lesions affecting the femoral head and neck in skeletally mature people. All circumstances had been handled with prolonged curettage by way of anterolateral modified Smith-Petersen strategy 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 accessible for comply with up. The age ranged from 18 to 43 years and the comply with 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 useful rating was good or glorious 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 useful end result and minimal recurrence fee will be achieved by salvaging the femoral head and neck utilizing curettage and reconstruction, obviating the necessity for alternative at such an early age.
PMID: 29416170 [PubMed]