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WIDE SURGICAL EXCISION FOR OSTEOID OSTEOMA TREATMENT. SHOULD IT BE THE FIRST CHOICE TREATMENT?



Abstract

Introduction: Osteoid osteomas (OO) are benign skeletal tumours with a predilection for the long bones of young patients. Many different methods are used for their treatment, conservative or operative, less or more radical with variable technology applications to destruct the “nidus”.

Material & Method: We present thirty eight patients with OO who were treated in our hospital between 1995–2001. Their medical records and radiographs are retrospectively reviewed and the patients were contacted and interviewed with a telephone discussion.

Results: In thirty two cases OO were located in the lower limb, two in upper limb and four in spine. Thirty seven of those were treated operatively using open wide excision of nidus in twenty two of which with additional bone grafting.In three of the cases after excision of OO, precautious internal fixation was applied to the bone. Two patients developed deep vein thrombosis, another two had increased pain in anterior superior iliac spine from the bone graft harvesting area. We had one recurrence, which was treated with a second operation.

Conclusion: We conclude that although the traditional method of treatment is the wide surgical excision, this technique has increased morbidity and higher risk for complications comparing to more minimally invasive procedures. We suggest that it should be the first choice of treatment for either spinal or recurrent OO.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.