Clinical Efficacy And Antatomic Research Of A Novel Surgical Approach For Benign Neoplasm In Lesser Trochanter

Objective This study attempts to investigate the operative feasibility and clinical efficacy of the operation approach, which is between femoral vessels and femoral nerve for benign neoplasm in lesser trochanter. Method12patients whom had benign neoplasm around lesser trochanter were collected during January2010to January2013. All neoplasm were resected or curetted by our novel approach. Pain degree, pre-operation and post-operation, was evaluated by Visual Analogue Scale (VAS). Imaging materials were assessed in follow-up. While,20cadaveric specimens were collected for anatomic study. The space between the outside of femoral artery trunk and the innermost branch of femoral nerve was observed and the distance of this space was measured in proximal of lesser trochanter4cm,2cm,0cm points and distal2cm,4cm,6cm points. Otherwise, the distance from the highest point of lesser trochanter to the beginning point of the lateral circumflex femoral artery was measured.Results Lesser trochanter was exposed clearly and neoplasms were resected or curetted radically. There was significant difference between pre-operation and post-operation in the VAS score (P<0.05). All the patients got follow-up after surgery. Average time was2.4years (range0.6to3years). Imaging materials were used to evaluate the effectiveness. No recurrence, femoral head necrosis, hip degenerative was found by radio graphic examination during follow-up time. Cadaveric study showed that11wee nerves were seen in6samples,2small branch arteries were seen in2specimens,1lymph vessel was seen in1specimen. The distance in4cm point proximal of lesser trochanter was (8.01±2.71)mm,2cm point was (9.65±2.60) mm,0cm point was (10.12±2.91) mm, and2cm point distal of lesser trochanter was (9.89±2.74)mm,4cm point was(9.58±2.86)mm,6cm point was (8.39±2.99) mm. The distance from the highest point of lesser trochanter to the beginning point of the lateral circumflex femoral artery was (12.56±9.74) mm.Conclusion It is some space existed that between the trunk of femoral artery and innermost branch of femoral nerve. Lesser trochanter and neoplasm were exposed clearly through our novel approach and neither vital neurovascular structures or complex content was existed in our operative area. All above, it can inferred that our novel approach is ideal approach to treat benign tumor and tumor-like lesion in lesser trochanter.