Osteoid Osteoma: a modified technique of conventional open excision

Osteoid osteoma is a benign, small but very painful bone tumour. The treatment consists of excision / destruction of nidus. In the past, conventional open excision of nidus was the usual treatment but now a days various other techniques have been described e.g. Percutaneous drilling , laser photocoagulation, chemical destruction or radio frequency ablation. These techniques have more predictable chances of nidus excision and fewer side effects. Although advocated currently but these newer techniques are not widely available everywhere in developing world. So open enblock excision is still the commonly used method for treatment in the developing world. We treated 5 cases of osteoid osteoma of long bones with modified open excision of tumour. Before definitive surgery for excision, we made a drill hole of 4 mm with an Steinman pin under local anaesthesia in the lesion and sent the patient for a repeat CT scan to know the exact location of the nidus in relation to the whole trajectory. During definitive surgery we located the hole trajectory and removed excised the nidus with very little cortical bone removal. In results all five patients were cured. The conclusion in this technique of open excision after CT localization is a safe, low cost and effective alternative to conventional en-block excision.