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BMJ Case Reports 2014; doi:10.1136/bcr-2013-202317
  • CASE REPORT

A mountain among molehills: removing an impinging large femoral neck osteochondroma in a man with hereditary multiple exostoses

  1. Kevin J Mulhall
  1. Department of Trauma and Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
  1. Correspondence to Dr Conall W R Fitzgerald; conallfitzgerald{at}gmail.com

Summary

A 31-year-old man with a history of hereditary multiple exostoses (HME) presented with persistent right groin pain and reduced hip range of movement. Examination demonstrated a positive FADIR (flexion, adduction and internal rotation) test suggesting femoroacetabular impingement (FAI). Investigations showed multiple sessile osteochondromata of the right femur with a dominant anterolateral femoral neck osteochondroma causing flexion block. The patient underwent an uncomplicated proximal femoral exostectomy. Six-week postoperative pain, range of movement and daily activity had greatly improved. This case highlights that even in the setting of multiple osteochondromata, excellent impingement relief can be achieved following selective proximal femoral exostectomy.

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