Oktay BELHAN, H. Bayram TOSUN, Lokman KARAKURT, Erhan YILMAZ, Erhan SERİN, Mehmet BULUT, Hanifi YILDIRIM

Uzun kemik yerleşimli osteoid osteomalı olgularda cerrahi tedavi sonuçları

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.

The surgical treatment results of cases with osteoid osteoma localized in long bones

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.

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