En bloc (Open) Excision in the Treatment of Osteoid Osteoma

Auday HH Al-Janaby
Department Of Orthopedics, Al-Zahrawi Hospital, Misan Health Directorate, Ministry Of Health/Environment, Misan, Iraq

Published on: 2021-05-24

Abstract

Background: The standard treatment for osteoid osteoma (OO) is conventional (en bloc) open excision. The study aimed to discuss the clinical outcomes and complications of the conventional (en bloc) open excision.
Methods: Twenty-five patients with OO were treated with (en bloc) open excision during a period from January 2015 to June 2020. The clinical ?ndings and radiological investigations and the operative data were recorded. Radiological assessment was based mainly on plain X-rays. The mean age of patients was 18 (range 16-32) years and the follow-up was ranged 3-5 years. The bone excised was sent for histopathology.
Results: Pain improved in 20 (80%) patients at the ?rst week postoperatively. In five patients (20%), the improvement gradual-onset during the ?rst 6 months. The complication included increased pain, foot drop, proximal fibula, neurapraxia and hematoma. There was no OO recurrence, no pathological fracture, and no postoperative infection.
Conclusions: Open (En bloc) excision of OO has the risk of increased morbidity and complications. When recommended, there are must be unavailable facilities and equipment to perform the percutaneous procedures.

Keywords

Osteoid Osteoma; Open Excision; En bloc

Introduction

Osteoid osteoma (OO) is one of the most common benign neoplasm of bone, predominant in adolescents and young adult’s male patients [1], and characterized by small, distinctive, non-progressive, and osteoblastic lesion [2]. It may occur in any site, but the common site is the appendicular bones. It is classified as cortical, cancellous, or subperiosteal. Cortical lesions are the most common [3]. In over 50% of cases, the lesions are centered on the cortex of femoral and tibial diaphysis, and mostly situated in cortico-diaphyseal or metaphyseal parts [4,5]. Radiologically characterized by small radiolucent area (nidus) surrounded by a thick zone of sclerotic bone. Several treatment options perform for OO, started from excision of the nidus [6], to percutaneous CT-guided core-drill excision [7], destruction of the nidus using radio-frequency thermo-coagulation [8], laser [9], or ethanol injection [10]. However, complete surgical excision was the gold standard for the treatment.
Here, we try to discuss the clinical outcomes and morbidity associated with (En bloc) open excision in the treatment of OO.

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