Complications of Computer Tomography Assisted Radiofrequency Ablation in the Treatment of Osteoid Osteoma.

BACKGROUND: Osteoid osteoma (OO) is one of the most commonly occurring benign bone tumors. It constitutes 10-12% of benign bone tumors and 2-3% of primary bone tumors. In radiofrequency ablation (RFA) treatment, the cells of the tumor are thermally inactivated by the help of electrodes shaped like needles. In our study, we aimed to show the major and minor complications in patients undergoing RFA and to show what should be done to prevent these complications. METHODS: The study was carried out as a prospective study on the follow-up of 87 osteoid osteoma patients treated between 2015 and 2017. The youngest of the patients was 1 year old and the oldest was 42 years old. The RFA procedure lasted 10 min on average, excluding anesthesia and preparation. All lesions were ablated at 90 degrees for 7 minutes with the heat increased gradually. All patients were followed up for 1 day in the orthopedics clinic. RESULTS: Complications were observed in 7 patients. The lesions with the most complications were observed to be in the tibia, second-degree burns were seen in 2 patients, and superficial skin infection was observed in 2 patients. In 1 patient, the probe tip was broken and remained within the bone. Intramuscular hematoma was detected in 1 lesion located in the proximal femur. A complaint of numbness in the fingers developed in a lesion located in the metacarpus. CONCLUSION: Preventive measures should be taken before the procedure in order to prevent minor complications, and, for major complications, close follow-up should be done after the procedure and patients should be kept away from heavy physical activities for the first 3 months.

Radiographic analysis of the lumbar and sacral region angles in young Turkish adults.

OBJECTIVE: To determine the normal angular ranges of the lateral spinal alignments in the lumbar and sacral regions. METHODS: This cross-sectional study was conducted at the Kilis State Hospital, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey, from February to August 2017, and comprised patients aged 18-27 years who underwent standardised standing lateral lumbar radiography to eliminate hip and low back disorders. All radiographs were obtained from the hospital database as well as the demographic and contact information of each subject. Patients were invited for an interview and physical examination. Standard standing lateral radiographs of the lumbar spine were obtained from those who had no complaint of back pain and/or lower back problems. Sacro-horizontal angle, lumbosacral joint angle and sacral inclination angle were measured on the radiographic images. SPSS 22 was used to analyse data. RESULTS: Of the 150 subjects evaluated, 80(53.33%) were women and 70(46.77) were men. There was no statistically significant difference between women and men regarding lumbar lordosis angle, sacro-horizontal angle and lumbosacral angle (p>0.05). Sacral inclination angle and lower limb length in men were greater than in women (p<0.05). A positive correlation was observed between the lumbar lordosis angle, sacral inclination angle and sacro-horizontal angle values, while a negative correlation with the lumbosacral angle (p<0.05). There was no relationship observed between age, weight, height and body mass index, and sacral inclination, sacro-horizontal and lumbosacral angle values (p>0.05). Lumbar lordosis angle increased depending on the increase of the body mass index (p<0.05). CONCLUSIONS: Values identified can be considered as reference values for young healthy Turkish adults.

Ultrasonography or direct radiography? A comparison of two techniques to detect dorsal screw penetration after volar plate fixation.

BACKGROUND: Complications related to extensor tendons have begun to increase with the use of volar plates in the treatment of distal radius fractures. In this study, we aimed to compare four-plane radiography and ultrasonography in the evaluation of dorsal cortex screw penetration following volar plate fixation. METHODS: We recruited 47 patients (33 males, 14 females, mean age 37.4 years; range 18-58 years). To evaluate dorsal screw penetration in all patients, we performed radiographs at 45° pronation, 45° supination and obtained dorsal tangential graphs at maximum palmar flexion, and a wrist lateral radiograph. Wrist ultrasonography was performed in all patients. RESULTS: Dorsal screw penetration was detected in 12 of the 47 patients undergoing VLP application. While there was > 2 mm screw penetration in seven patients, there was < 2 mm screw penetration in five patients. On four-plane radiographs, screw penetration > 2 mm was detected in seven patients and screw penetration < 2 mm was detected in two patients. On four-plane radiography, dorsal screw penetration was not detected in three out of five patients, who were shown to have < 2 mm screw penetration by ultrasonography. In addition to perioperative four-plane radiographs are also required to detect dorsal cortex penetration in patients undergoing VLP due to distal radius fracture. However, the detection of screw penetrations < 2 mm is more likely with ultrasonography compared to four-plane radiography. CONCLUSION: We recommend that dorsal cortex screw penetration should be evaluated with perioperative ultrasonography. TRIAL REGISTRATION: Research Registry, researchregistry3344 , Registered 10 January 2017.

Epithelioid Angiosarcoma in Femur: A Case Presentation.

Primary malignant vascular tumors which constitute less than 1% of the primary bone tumors are very rarely encountered. Epithelioid angiosarcoma is a very uncommon subtype of angiosarcomas presenting with an epithelioid phenotype and mimicking carcinomas clinically. These tumors select mostly extra-skeletal locations but rarely bones as their medium. A 31-year-old male patient applied to our clinic with a nonspecific left hip pain. X-ray evaluation revealed a cystic expansile mass in the trochanteric region of the femur extending to the femoral neck. Computed tomography examination proved that the mass was cystic and 7 cm in its greatest width and contained septum. Moreover, magnetic resonance imaging examination was reported as a mass resembling aneurysmal bone cyst. The final diagnosis of epithelioid angiosarcoma was made by histological examination and biopsy of the mass. The excised specimen was examined further to verify the preoperative diagnosis.