36 yrs. Male having pain for 5 months in rt hip . Felt by itself and presented with this picture. I did curatage and filled cancellous bone graft and fixed. Curated material send for biopsy. Opinion please regarding my attempt.
Mohammed Ahmed RefayYour attempt is very good. But I want to know what was the pathology, curettage done through window in the trochanter or you opened the capsule and did direct curettage and what approach you used?
Sanjay Ganorkarattempt good ..but for the patient leaves behind a feeling that something is missing ..if your curettage shows a benign lesion you are through with your effort but what about the vascularity of the head and the ultimate healing ..good procedure anyway
Baher SamyIf the biospy came out with a malignant lesion then this is a catastrophy, and if it’s benign then non-union or fixation failure is likely to occur. Better have well investigated and biposied first then manage accordingly
Abhijit KhadeIf u hav cureted through trochanter then it is insuficient … U hav to 1st do mri then needle biopsy and then anterior aproach curetage wth lateral dhs plate wth bone graft… V had done same kind of case wth sp aproach
Yogesh GaikwadGood job, at least you try to preserve normal head. Done similar case 4 yr back .Turn out ABC.Keep non wt bearing till at least 3 month.Thomos splint for earlier post op period. Attaching similar case.will post follow up x ray.
Ashish GuptaMany of us are saying fibula . & most likely non vascularized ( nagi’s) .one of my friend frm PGI chd told me they followed these pt by CT & these fibula were not incorporated even after 2-3 years . so believing that non vascularized fibula is a good option may not be very wise
Ashish GuptaRegarding this case there r few issues as mentioned earlier , preop biopsy, quantity of graft , and quality of purchase lag screw is having as there is not much bone present in head. But a decent attempt. If succeed ,then nothing better . i did 3 cases like this ( non of them were this big lesions ). 2 healed & one is just 2 months follow up.