Talus localized osteochondromas: Treatment management and mid-term outcomes - Case series.

OBJECTIVES: This study aims to define the demographic and clinical findings of patients with talus localized osteochondroma, to present treatment management and mid-term results. PATIENTS AND METHODS: The study included 10 patients (4 males, 6 females; mean age 31.9+19.5 years; range, 11 to 70 years) with osteochondroma of the talus who were admitted to our center between January 2008 and December 2015. Clinical findings, treatment methods, and clinical outcomes were retrospectively evaluated. All patients were followed-up for at least two years. RESULTS: The most frequent localization was anterior of the talus (70%, n=7). The mean tumor size was 2.4±1.4 cm (range, 1-5 cm). When the relationship between tumor diameter and age was analyzed, no statistically significant correlation was detected (p=0.973). Besides, no statistically significant difference was found between the genders in terms of tumor diameters (p=0.584). The most common symptoms were pain, swelling, and restricted movements. The mean duration of postoperative follow-up was 48.1±27.7 months (range, 24-114 months). All patients underwent complete surgical excision. None of the patients developed recurrence or complication related to the treatment of osteochondroma. CONCLUSION: Talus localized osteochondromas are often symptomatic and more common in adults. Also, they are more common in females. The ideal treatment approach is resection of the tumor. When rigorous surgical excision is performed, recurrence rates are low with satisfactory outcomes.

Atypical femoral fracture following zoledronic acid treatment.

A 68-year-old female patient admitted to our clinic with right anterior thigh pain ongoing for six months and which increased in last two months. The patient had no trauma history. The patient had been followed-up for 15 years because of osteoporosis and administrated alendronate and ibandronate treatment for 10 years. Patient had three shots of zoledronate once a year during the last three years. Her pain was increasing when she was walking. Physical examination revealed pain in her right thigh. Radiogram showed thickened lateral cortex of the subtrochanteric area. Magnetic resonance imaging also showed thickening and edema of the same area. These images were correlated with atypical fracture in right femoral subthrochanteric zone. Dual energy X-ray absorptiometry revealed that T score was -3.3 in lumbar region and -2.5 in femoral neck. Zoledronate treatment was ended. Prophylactic surgical fixation was performed with titanium elastic nails.