Excision of a Distal Tibial Interosseous Osteochondroma Through Posterolateral Approach: A Case Report

TL;DR

This case report describes a new surgical approach for removing a rare ankle tumor without cutting bones or causing major complications.

Contribution

A novel posterolateral surgical approach is introduced for excising distal tibial osteochondromas.

Findings

The posterolateral approach avoids fibular osteotomy and reconstruction.

The method reduces injury risk to neurovascular structures.

It allows faster recovery and return to activity.

Abstract

Osteochondromas arising from the interosseous border of the distal tibia are rare, but cases have been reported previously in the literature. In long-standing cases, they can cause a "mass effect" resulting in the deformation of the bones around the ankle joint, mechanical restriction of joint movement, and even degenerative joint disease. Hence, they need to be resected if patients present with such impending complications. Several surgical techniques have been described previously for tumor resection including the anterior approach and the trans-fibular approach, the latter of which required a fibular osteotomy with or without fibular reconstruction. The surgical technique described here utilizes the posterolateral approach to the ankle joint for tumor excision, thus avoiding the need for any osteotomy or fibular reconstruction and reducing the risk of injury to major neurovascular structures. It also reduces the need for long-term immobilization and promotes a faster return to activity.

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