The Surgical Treatment Results of Cases with Osteoid Osteoma Localized in Long Bones

Year 2010, Volume: 15 Issue: 2, 87 - 91, 01.04.2010

Oktay Belhan H. Bayram Tosun Lokman Karakurt Erhan Yılmaz Erhan Serin Mehmet Bulut Hanefi Yıldırım

Abstract

Objective: The evaluation of various surgical treatment results performed to cases with long bones localized osteoid osteoma retrospectively. Materials and Methods: Ten patients (5 male, 5 female; mean age 21; range 13-35) who underwent surgical treatment because of long bones localized osteoid osteoma were evaluated retrospectively. Osteoid osteomas were localized as femur shaft in 5 cases, as tibia shaft in 2 cases, as femur neck in 1 case and as humerus shaft in 2 cases. There was a history of night pain responding to non-steroid antiinflammatory drugs (NSAİİ) in 6 cases. In surgical treatment, nidus was completely excised by wide-block resection, burr-down technique. Results: With osteoid osteoma diagnosis, nidus excision was applied with wide-block resection to 5 cases and burr-down technique to 5 cases. The spongious allografts were applied in three cases because of the weaken of bone at the during surgery, and spongious allografts with internal fixation were applied in two cases for the risk of pathological fracture No complications were encountered in any cases during and after the operation. In their last controls, cases were completely asymptomatic and there was no recurrence in any of them. Conclusion: We think that, by determining the location of nidus exactly before and during the operation and excision of nidus completely, sufficient and effective results could be obtained in osteoid osteoma treatment.

Keywords

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Uzun Kemik Yerleşimli Osteoid Osteomalı Olgularda Cerrahi Tedavi Sonuçları

Abstract

Amaç: Uzun kemik yerleşimli osteoid osteomalı olgulara uygulanan farklı cerrahi tedavi sonuçlarının retrospektif olarak değerlendirilmesi. Gereç ve Yöntemler: Uzun kemik yerleşimli osteoid osteoma nedeniyle cerrahi tedavi yapılan10 hasta (5 erkek, 5 kadın; ortalama yaş 21; dağılım 13-35) retrospektif olarak değerlendirildi. Osteoid osteomalar 5 olguda femur cisim, 2 olguda tibia cisim, 1 olguda femur boyun ve 2 olguda ise humerus cisim yerleşimliydi. 6 olguda nonsteroid antiinflamatuar ilaçlara (NSAİİ) cevap veren gece ağrısı öyküsü mevcuttu. Cerrahi tedavide, en blok rezeksiyon, burr-down tekniği ile nidus tamamen çıkarıldı. Bulgular: Osteoid osteoma tanısıyla 5 olguya geniş en blok rezeksiyon, 5 olguya ise, burr-down tekniği ile nidus eksizyonu uygulandı. Cerrahi sırasında kemiğin zayıflatılması nedeniyle 3 olguda spongioz allogreft kullanılarak greftleme, 2 olguda ise patolojik kırık riski nedeniyle spongioz allogreft kullanılarak greftleme ile birlikte internal tespit yapıldı. Hiçbir olguda ameliyat sırasında ve sonrasında komplikasyonla karşılaşılmadı. Son kontrollerinde olgular tamamen asemptomatikti ve hiçbirinde nüks görülmedi. Sonuç: Osteoid osteoma tedavisinde, nidus yerinin ameliyat öncesi ve ameliyat sırasında tam olarak belirlenmesi ve nidusun tam olarak eksize edilmesi ile yeterli ve etkili sonuç elde edilebileceğini düşünmekteyiz.

Keywords

Osteoid osteoma, tanı, cerrahi, tedavi

References

• 1. Ofluoğlu Ö, Erol B, Mık G, Coşkun C, Yıldız M. Uzun kemik yerleşimli osteoid osteomada görüntüleme yardımlı minimal invaziv cerrahi. Acta Orthop Traumatol Turc 2006; 40: 207-213.
• 2. Aynacı O, Şener M, Aydın H, Gürcan O. Proksimal femur yerleşimli osteoid osteomalar (on iki olgunun değerlendirilmesi). Acta Orthop Traumatol Turc 2001; 35: 95-98.
• 3. Campanacci M, Ruggieri P, Gasbarrini A, Ferraro A. Direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg Br. 2000; 82: 306- 307.
• 4. Ward WG, Eckardt JJ, Shayestehfar S, Mirra J, Grogan T, Oppenheim W. Osteoid osteoma diagnosis and management with low morbidity. Clin Orthop 1993; 291: 229-235.
• 5. Jaffe HL, Lichtenstein L. Osteoid-osteoma: Further experience with this benign tumor of bone: With special reference to cases showing the lesion in relation to shaft cortices and commonly misclassified as instances of sclerosing non-suppurative osteomyelitis or cortical-bone abscess. J Bone Joint Surg Am 1940; 22: 645-682.
• 6. Ghanem I, The management of osteoid osteoma: Updates and controversies. Curr Opin Pediatr 2006; 18: 36-41.
• 7. Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am 1998; 80: 815-821.
• 8. Hosalkar HS, Garg S, Moroz L, Pollock A, Dormans JP. The diagnostic accuracy of MRI versus CT imaging for osteoid osteoma in children. Clin Orthop 2005; 433: 171-177.
• 9. Gitelis S, Wilkins R, Conrad EU. Benign bone tumors. J Bone Joint Surg Am 1995; 77: 1756-1782.
• 10. Bilgin SS, Yıldız Y, Güçlü B, Sağlık Y. El yerleşimli osteoid osteomlu sekiz olgunun değerlendirilmesi. Acta Orthop Traumatol Turc 2004; 38: 206-211.
• 11. Ponseti I, Barta CK. Osteoid osteoma. J Bone Joint Surg Am 1947; 29: 767-776.
• 12. Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid-osteoma. J Bone Joint Surg Am 1992; 74: 179-185.
• 13. Stanitski CL (Ed), Lee EH, Shafi M, Hui JHP. Osteoid Osteoma: A Current Review. J Pediatr Orthop 2006; 26: 695-700
• 14. Moberg E. The natural course of osteoid osteoma. J Bone Joint Surg Am 1951; 33: 166-170.
• 15. Herring JA (Ed). Tachjian’s Pediatric Orthopedics. Centel T, Seyahi A (Eds), İstanbul: Hayat Tıp Kitapçılık 2007: 1933-1936.
• 16. Sherman MS. Osteoid osteoma: Review of the literature and report of thirty cases. J Bone Joint Surg Am 1947; 29: 918-930.
• 17. Maclellan DI, Wilson FC. Osteoid osteoma of the spine: A review of the literature and report of six new cases. J Bone Joint Surg Am 1967; 49: 111-121.
• 18. Ayala AG, Murray JA, Erling MA, Raymond AK. Osteoidosteoma: İntraoperative tetracycline-fluorescence demonstration of the nidus. J Bone Joint Surg Am 1986; 68: 747-751.
• 19. Helms CA. Osteoid osteoma: The double density sign. Clin Orthop 1987; 222: 167-173.
• 20. Graham HK, Laverick MD, Cosgrove AP, Crone MD. Minimally invasive surgery for osteoid osteoma of the proksimal femur. J Bone Joint Surg Br 1993; 75: 115-118.
• 21. Sim FH, Dahlin CD, Beabout JW. Osteoid-osteoma: Diagnostic problems. J Bone Joint Surg Am 1975; 57: 154-159.
• 22. Dunlop JAY, Morton KS, Elliott GB. Recurrent osteoid osteoma: Report of case with a review of the literature. J Bone Joint Surg Br 1970; 52: 128-133.