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The case of 'A Rhino Horn': case report and proposal for modification to the Hetsroni and Kelly classification.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Marín-Pena, Oliver 
Tey-Pons, Marc 
Mas-Martinez, Jesús 
Dantas, Pedro 

Abstract

Subspine impingement syndrome by definition involves a prominent antero-inferior iliac spine (AIIS) which can lead to impingement on the femoral neck thereby causing symptoms. We present the case of a 22-year-old semi-professional athlete who presented with a Type III AIIS morphology leading to subspine impingement syndrome and was managed via a mini open anterior approach. Radiological examination revealed a fairly prominent left AIIS resembling the 'horn of a rhino' extending to the trochanteric region anteriorly. A mini-anterior surgical approach was utilized for the resection of the 'rhino horn' and the rectus femoris was reattached. The patient remained asymptomatic at the one-year follow-up and had resumed weightlifting. Following this case, we propose a new classification of the type III AIIS morphology in view of the clinical presentation. The AIIS type III-Standard represents an extension from the acetabular rim to less than 1 cm (type III-S) and type III-Large, with an extension from the acetabular rim beyond 1 cm (type III-L). The type III-L will further be divided into two groups based on its relation to the ilium, type III-Lr ('rib shape') and type III-Lrh ('rhino horn').

Description

Keywords

32 Biomedical and Clinical Sciences, 3202 Clinical Sciences

Journal Title

J Hip Preserv Surg

Conference Name

Journal ISSN

2054-8397
2054-8397

Volume Title

8

Publisher

Oxford University Press (OUP)