OSTEOCHONDROMA OF THE POSTERIOR FEMORAL NECK: A RARE CAUSE OF SCIATIC NERVE COMPRESSION

Sanjay Yadav, Pankaj Maurya, Mohit Kumar, Rajkumar Arya

Abstract


INTRODUCTION: Osteochondroma is the most common primary benign bone tumor and comprises a third of
these tumors. They are usually extraarticular secondary to their common origin from metaphysis of long bones.
Osteochondroma of the femoral neck is atypical as they represent an intraarticular lesion. They are mostly asymptomatic depending on
their size and location.
CASE STUDY: An eighteen year old male presented to us with complaint of pain in left posterior hip region, difficulty in sitting on hard
surface, mass in buttock associated with tingling sensations in left lower limb since eight months. On examination, sensations were
decreased on plantar and dorsal aspect of left foot. Motor power was diminished for both ankle plantar and dorsi􀃸exors. A 􀃶rm to hard
pedunculated mass measuring 12 x 10 cm was palpated on posterior femoral neck which was con􀃶rmed on plain radiographs. CT and MRI
were done to further delineate the anatomy and cartilage cap assessment.
MANAGEMENT: Surgical intervention in the form of extra-periosteal resection was performed through posterior approach. Intraoperatively,
sciatic nerve was found to be stretched on medial aspect of tumor. Post-operatively symptoms resolved dramatically. At follow
up, patient had full resolution of neurologic 􀃶ndings. Histopathology report con􀃶rmed the diagnosis of osteochondroma.
CONCLUSION: one should be aware of rare entities such as proximal femur osteochondroma during diagnosis and treatment of sciatic
neuropathy along with other common etiologies.


Keywords


Osteochondroma, femoral neck, sciatic nerve, compression, resection

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References


Yu K, Meehan JP, Fritz A, Jamali AA. Osteochondroma of the femoral neck: A rare cause of sciatic nerve compression. Orthopedics 2010; 33: 625-6

Turan Ilica A, Yasar E, Tuba Sanal H, Duran C, Guvenc I. Sciatic nerve compression due to femoral neck osteochondroma: MDCT and MR findings. Clin Rheumatol 2008; 27: 403-4

Siebenrock KA, Ganz R. Osteochondroma of the femoral neck. Clin Orthop Relat Res 2002; 394: 211-8


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