Title : Improving global mortality and outcomes in neck of femur fracture management
Abstract:
Introduction: Primary bone tumours of the lesser trochanter (LT) are rare and the literature describing them is sparse. We describe the largest series of LT tumours reviewing the demographics, diagnosis and management.
Methods: A retrospective search of prospectively maintained radiology and oncology databases was performed to identify bone tumours of the LT diagnosed between 2007 and 2018. Metastatic lesions were excluded. All cases were rereviewed by a senior Consultant Radiologist and all case of benign isolated tumours of the LT were included.
Results: 23 cases of isolated LT tumours were identified. There were 15 males and 8 females. Median age of our cohort was 32 (14 - 63) years. Most (n=19, 82.6%) cases had classic radiological (Radiographic, MR Imaging and CT) features and therefore did not undergo biopsy. 4 patients had equivocal radiological investigations that required biopsy to confirm the diagnosis. MR imaging was the most commonly used imaging modality for diagnosis (n=17, 73.9%)
There was a broad range of tumour subtypes, and osteochondroma (n=17, 73.9%) the most frequently diagnosed. Surgical excision was performed in 4 patients (all osteochondromas) and 4 patients underwent therapeutic radiological guided hip injections for symptomatic relief. The remaining cases were managed conservatively. Where they were identified incidentally, no intervention was required.
Conclusion: We report the largest case series of isolated primary bone tumours of the LT. All isolated primary bone tumours of LT are benign. Osteochondroma is the most common. The diagnosis can be made with on radiological investigations in most patients.
