Femur osteochondroma is the most common disease in which a benign neoplasm develops on the bone tissue. Deviation is detected mainly in the younger generation, that is, while the bone structure is developing. In other words, it is young people and adolescents (regardless of gender) that are at risk of this disease. The resulting neoplasm ends its development by 25-30 years. But what exactly is it? About this and much more - further.
What is osteochondroma
As noted above, the term "osteochondroma" should be understood as a cartilaginous neoplasm, which is usually characterized by a benign character. Inside it, a bone structure develops. This implies the medical term - bone-cartilage exostosis. A neoplasm begins to form in the metaepiphyseal part of the bone and, as a person grows, is shifted to the diaphysial.
At the same time, the tumor itself does not pose any serious threat to human health, even though the osteochondroma of the femur is visible. At the same time, under certain circumstances, it can develop into a malignant neoplasm. Despite the benign nature, osteochondroma causes a pronounced cosmetic defect, which can greatly affect the mental health of patients.
On average, the size of the tumor in most cases does not exceed 12 cm. But in medical practice, cases have been reported when it reached slightly larger dimensions - about 200 mm or more.
Often, many doctors believe that the appearance of osteochondroma is due to improper development of the bone structure. After all, a tumor, appearing in a child, grows along with its development. While it is small, it does not bother him, but with its increase, a matured young man may already experience serious discomfort.
Tumor structure
About what is the osteochondroma of the femur, we have an idea. Certain risks were also introduced. But what is the structure of the neoplasm? In fact, this is an additional growth on the surface of the femur and in its structure resembles the articular end, which contains the following layers:
- Outer, cartilaginous - has a smooth and shiny surface, in shape resembles a hat, which in thickness can reach several millimeters.
- The layer of bone tissue is dense and durable.
- Spongy bone - it is pierced by blood vessels. In this layer there can be islands of cartilage and mature bone tissue.
- The medullary canal is located in the very center of the neoplasm. It communicates with the cavity of the main bone.
Moreover, all these layers of the tumor do not have a clear morphological structure and boundaries - they kinda grow on top of each other. This, in fact, is the main and distinguishing feature of the osteochondroma of the femur in adults.
What is characteristic, it is not known for certain how many people around the world suffer from such a benign disease. This is due precisely to the fact that the neoplasm grows with a person and may not bother him for many years. In some cases, patients live quietly with this pathology to a very old age. At the same time, it can be detected purely by chance during radiography or for some other reason.
Neoplasm classification
Osteochondroma is divided into two main types:
- Multiple (osteochondromatosis, or Olier disease) - this form of pathology is formed on long bones (tibia). In this case, neoplasms are located at a fairly large distance from each other.
- Single - as you can understand, this is a bone-cartilage tumor in a single copy. This type of disease is much more common than the previous form.
Three stages of the formation of osteochondroma of the femur are also distinguished:
- I - the formation of a growth from cartilaginous tissue, which is impossible to palpate.
- II - ossification of the neoplasm with its subsequent increase. Hard tissue is covered with cartilage, but continues to grow rapidly.
- III - cessation of bone growth. In this case, only the “head” of the osteochondroma increases. During physical activity, pain and inevitable difficulties may appear.
In addition to this, neoplasms can either be located on the very surface of the bone or grow on the leg.
Development reasons
The exact reasons for the development of osteochondroma for most traumatologists and orthopedists are still a mystery. However, experts are inclined to believe that the appearance of a benign tumor may be associated with a congenital pathology that develops while the bone grows. That is, when in the womb the epiphyseal plate is displaced during the formation of the baby’s bones.
At the same time, the tumor can reach even small sizes only by 10-12 years of the child's life. It should be noted that in the photo osteochondroma does not look very attractive.
In addition, experts do not exclude the impact of external and internal factors on tumor growth. Nevertheless, its appearance may be due to a number of negative factors:
- popliteal vein thrombosis;
- false popliteal artery aneurysm;
- frequent fractures;
- infectious diseases;
- severe bruises;
- violations of the endocrine system.
In addition, it was found that the effect of radiation on the human body can also be a provoking factor for the appearance of a tumor. In other words, if a child has undergone treatment using radiation therapy, then the chances of a neoplasm appearing increase. About 10% of people with oncology developed osteochondroma.
Diagnosis of osteochondroma
If you find obvious signs of developing osteochondroma of the femur, you should consult a doctor to refute or confirm the diagnosis. Typically, patients visit an orthopedic surgeon or surgeon. In this case, the specialist, first of all, draws attention to the age of the patient - if a child or adolescent addresses him, he makes an assumption about the probable growth of the tumor.
During the study of the anamnesis, the doctor is obligatory interested in patients who have or have had a previous pathology of a similar form in their immediate family. It is also important to consider whether patients have been exposed to radiation exposure in the past. The condition of the body is also important.
Methods for conducting diagnostic tests
In most cases, multiple or single osteochondroma is detected purely by accident, just during the diagnosis.
But in order to confirm or exclude the likelihood of conversion of osteochondroma into a malignant tumor, it is necessary to conduct a thorough diagnosis. It includes a number of studies:
- X-ray - allows you to visually determine not only the localization of the neoplasm, but also its structure. Bone destructive processes can also be detected.
- CT and MRI - a more detailed visualization of the tumor, which allows you to study its contents. This study just allows you to determine the nature of the course of osteochondroma. In addition, you can assess the condition of the immediate environment: tissues, small blood vessels, nerve endings.
- Ultrasound - using ultrasound, you can identify hypoechoic areas in the structure of the neoplasm.
- Biopsy - if there is a suspicion of the development of oncology, this study will allow you to make an accurate diagnosis.
Only after carrying out all the necessary diagnostic measures is a prognosis made and a scheme for further treatment of osteochondroma drawn up.
Treatment features
A benign tumor, if it is small and does not cause noticeable discomfort to patients (pain, discomfort, etc.), does not need treatment. The main thing is that the tumor does not prevent a person from leading a full-fledged lifestyle.
Nevertheless, since it was detected during diagnostic tests, close monitoring is necessary. It is important not to lose sight of the child’s complaints - does he feel pain during physical education. No less important is the size of the neoplasm - ideally, when the tumor does not grow. For this, patients undergo x-rays several times during the year. This allows you to keep the dynamics of the osteochondroma, and if it grows, it will be detected in time.
As you might guess, conservative therapy is useless against osteochondroma of the femur. Operation is the only option. And since this is a serious intervention in the work of the human body, it is carried out in the most extreme cases.
Indications for surgery
There are certain indications according to which doctors prescribe patients surgical treatment:
- osteochondroma has a large size;
- rapid tumor growth;
- deformation of the skeleton in a child;
- impaired motor function of the limb;
- circulatory disturbance due to compression of the arteries and veins by the tumor;
- Patients are constantly worried about severe pain.
What is characteristic, the operation is prescribed not to all patients, since doctors take into account a number of important factors - age and its general condition, tumor location, the nature of the course of osteochondroma, and a number of others. Although surgery is the only solution to the problem, it does not always end favorably for the patient.
In addition, even after removal of the osteochondroma, it may appear again. As a rule, relapse occurs within 2 years after the neoplasm is removed. Again, this probability is due to the fact that the surgeon did not remove the entire tumor and some part of it remained (a kind of "root system").
Surgical intervention
Nowadays, there are many ways to improve, and in traumatology there is such a procedure as bone grafting, or osteoplasty. This is a bone transplant in order to restore it and replace defects. But since bone tissue itself is not damaged due to osteochondroma, there is no need for such a procedure.
Everything is done by the traditional method:
- To begin with, the patient is immersed in deep sleep through anesthesia.
- The surgeon treats the surface of the skin with an antiseptic.
- At this stage, the doctor performs a dissection of the skin.
- Now you can begin to remove the tumor and its legs (if any).
- At the final stage, the wound is sutured.
After the procedure, it is impossible to load the operated leg heavily for several months. It is necessary to verify the absence of recurrence of osteochondroma of the femur. The operation can be fully considered successful when subsequently signs of the return of the disease are not detected.
If you ignore these recommendations and immediately after wound healing begin to engage in sports, then it threatens with fractures and other injuries. The affected tissues are still inflamed and weak.
Rehabilitation period
During the entire rehabilitation period, the patient needs complete physical rest. During the first two or three weeks, a course of rehabilitation therapy is carried out in a hospital. At the same time, patients take preventive and restorative medicines.
After the patients are discharged, they remain under the supervision of doctors and undergo diagnostic tests in accordance with the established schedule. Usually, the prognosis after surgery is favorable. The likelihood of recurrence of osteochondroma, although there is, is minimal.
In conclusion
As a rule, the development of a tumor on the femur does not turn into a serious danger, and the operation ends successfully in the fight against osteochondroma. After surgical treatment, patients are closely monitored by doctors who monitor the dynamics of the neoplasm. At the same time, there is a risk of complications and the transformation of osteochondroma into a malignant tumor. However, this happens in rare cases. In addition, it still depends on the qualifications of surgeons.
Especially experts are concerned about fast-growing and multiple neoplasms. Otherwise, patients can do without proper treatment, only from time to time they have to undergo diagnostic tests.