case_images: PMC11810139_01
case_images: Tumor size.. (a and b): Indicating the site and the size of the tumor.
case_images: cureus-0017-00000077295-i01.jpg
case_images: PMC11810139_01_cureus-0017-00000077295-i01.jpg
case_images: FIG1
case_images: Preoperative plain radiograph, three-dimensional CT reformatted image, and MRI scan.. a. Preoperative plain radiograph of the right forearm showed an expansile bony lesion in the proximal end of the right radius with a dislocation of the radio-humeral joint and an increase in the bowing of the radial shaft. Additionally, there is evidence of distal radioulnar abnormal articulation as part of MHE.. b. The preoperative three-dimensional CT reformat image showed an expansile bony lesion in the proximal end of the right radius with a dislocation of the radio-humeral joint and bone absorption in the lateral aspect of the humeral trochlea due to the abutment of the bony lesion. The ulna had no significant shortening or angular, varus, or valgus deformities.. c. Preoperative MRI demonstrates a cauliflower-like bony outgrowth (Red circle) arising from the lateral metaphysis of the proximal radius (yellow circle), which measures approximately 51x41x48 mm. It shows preserved cortical and medullary continuity with the parent bone. The cartilaginous cap thickness measures about 3 mm.. (Green circle= proximal ulna) (Light blue circle= forearm flexors muscles) (Dark blue circle= mobile wad muscles) (Red arrow= neurovascular bundle).
case_images: cureus-0017-00000077295-i02.jpg
case_images: PMC11810139_01_cureus-0017-00000077295-i02.jpg
case_images: FIG2
case_images: Additionally, there is evidence of distal radioulnar abnormal articulation as part of MHE (Figure 2a). The ulna had no significant shortening or angular, varus, or valgus deformities (Figure 2b). The cartilaginous cap thickness measures about 3 mm (Figure 2c).
case_images: Intraoperative Steps: Skin approach, tumor exposure, posterior interosseous nerve identification, and fascial strip application.. a. Shows an extended lateral skin approach directly over the lesion.. b. Demonstrates the tumor exposure by the elevation and the dorsal reflection of the fascio-muscular flap.. c. Illustrates the location and the integrity of the posterior interosseous nerve.. d. A fascial strip was warped around the radial shaft.
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case_images: PMC11810139_01_cureus-0017-00000077295-i03.jpg
case_images: FIG3
case_images: Subsequently, the anconeus muscle and the forearm extensors fascio-muscular flap were elevated sharply from the medial surface of the ulnar shaft and reflected volar to completely expose the bone lesion and the dislocated radio-humeral joint (Figure 3a, Figure 3b). Throughout the dissection, the posterior interosseous nerve (PIN) was identified and protected (Figure 3c). Lastly, a deep fascia strip from the right forearm was utilized to reconstruct a simulation of the annular ligament (Figure 3d). 
case_images: Size of the resected sample.. Images a and b indicate the size of the resected sample, which is 7 cm wide and 6 cm long.
case_images: cureus-0017-00000077295-i04.jpg
case_images: PMC11810139_01_cureus-0017-00000077295-i04.jpg
case_images: FIG4
case_images: The histopathological examination of the resected specimen revealed osteochondroma, which was consistent with the preoperative diagnosis (Figure 4a, Figure 4b). 
case_images: One-year postoperative plain radiograph.. One-year postoperative plain radiograph of the right elbow joint showed mild elbow valgus deformity with no radial shaft proximal migration or tumor recurrence.
case_images: cureus-0017-00000077295-i05.jpg
case_images: PMC11810139_01_cureus-0017-00000077295-i05.jpg
case_images: FIG5
case_images: During the follow-up, the plain radiograph showed mild elbow valgus deformity with no radial shaft proximal migration or tumor recurrence (Figure 5).