[Diagnosis and treatment of osteoid osteoma]

To study the clinical features and surgical treatment of osteoid osteoma and improve the diagnostic therapeutic level.

Clinical data of 35 patients (25 males and 10 females) with osteoid osteoma diagnosed and treated between January 1997 to October 2009 were retrospectively reviewed. The average age was 21 years (ranged, 6 to 49 years). The average interval time between onset of symptoms and diagnosis was 12 months (ranged, 1 to 24 months). The most common sites were the tibia (13 patients) and the femurs (7 patients). The most common presenting complaints for patients with osteoid osteoma was pain which usually responded to NSAIDs and was generally more severe at night. The imaging manifestations revealed a circular or oval nidus. All the patients underwent surgical treatment. The tumors were treated with curettage or excision with autograft or allograft in 19 patients, simple surgical resection in 9 patients, curettage or excision with autograft or allograft and fixation in 7 patients.

The mean follow-up period was 49 months (ranged,2 months to 12 years). The symptom of pain disappeared after operation. There were no evidence of recurrence. Tibial pathological fracture happened in one patient 4 months postoperatively, and the patient got healing after plate-screw internal fixation. One patient with sinus formation 5 years postoperatively got wound healing after sinus resection, intramedullary nail removal and debridement.

According to the typical clinical presentation, radiographic findings, the diagnosis of osteoid osteoma is not difficult. Once the diagnosis is confirmed, the operation should be carried out as early as possible to relieve the symptoms, improve the quality of life and prevent long-term complications.