PMC7276578_01
(a) Pre-operative X-ray of the left hip. (b and c) Pre-operative X-ray of the left elbow lateral and anteroposterior.
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F1
X-ray of the left hip showed bar of mature bone connecting the lateral part of superior pubic ramus to the lesser trochanter (Fig. 1). X-ray of the left elbow showed bony mass arising from anterior aspect of humerus directed distally with length of 9.3 cm (Fig. 1).
(a) Pre-operative computed tomography (CT)angiography -three-dimensional (3D) reconstruction showing external iliac and femoral artery crossing the bony mass.(b) Femoral artery tenting over the bony mass shown by yellow arrow.(c) Pre-operative CT - 3D reconstruction - dimensions of bony mass.
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F2
Bony mass had dimensions of length 8.3 cm x 4 cm (Fig. 2).
(a) Bony mass dissected in subinguinal approach. Femoral vascular bundle and femoral nerve looped in separate infant feeding tube.(b) Osteotome used to detach the mass from the pubis.
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F3
The bony mass was detached from pubis and femur with an osteotome (Fig. 3).
(a) Two-year post-operative X-ray of pelvis with both hips showing no evidence of recurrence.(b) Clinical picture showing comfortably sitting cross-legged.(c) Clinical picture showing comfortably squatting.(d) Clinical picture showing hip flexion of 120degree.
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F4
X-ray taken at 2-year follow-up showed no recurrence (Fig. 4).
(a) Two-year post-operative X-ray of the left elbow anteroposterior view - showing no evidence of recurrence.(b) Two-year post-operative X-ray of the left elbow lateral view - showing no evidence of recurrence(c) Clinical picture showing full extension of the left elbow.(d) Clinical picture showing 120 C flexion of the left elbow.(e) Clinical picture showing 80 C supination of the left elbow.(f) Clinical picture showing 60 C of pronation of the left elbow.
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F5
X-ray at 2-year follow-up showed no recurrence and serum alkaline phosphatase levels were 90 U/L (Fig. 5).