Excision of osteochondroma from the medial distal femur surgical technique
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Osteochondromas represent approximately 1/3 of all benign bone tumours. They are an exostosis of bone that is covered by cartilage on its external surface. They typically present in the second or third decades of life and most frequently effect the appendicular skeleton, with the lower limbs more commonly effected. They may be solitary or multiple hereditary osteochondromatosis. The risk of sarcomatous change is rare, seen in approximately 1% of solitary osteochondromas, with rates of 1-25% seen in multiple hereditary osteochrondromatosis.
Surgery for benign osteochondromas should be avoided and only performed if they cause pain, decreased range of motion, pressure on neurovascular structures, tendon irritation or significant bursal formation.
In this case a young male patient had pain and limitation of deep flexion, which was interfering with his active job. Previously he had suffered a fracture of the stalk of the osteochondroma. A period of conservative management had been tried prior to offering excision. An MRI pre-operatively confirmed there was no suggestion of malignant transformation.
Author: Mr Richard Baker MD, MSc, MB.ChB, FRCS (Tr & Orth).
Institution: The Avon Orthopaedic Centre, Bristol, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
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The pass mark is 75%.
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- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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