Finite Element Analysis Could Predict and Prevent a Pathological Femoral Shaft Fracture after En Bloc Resection of a Large Osteoid Osteoma

Abstract

Osteoid osteoma is a benign tumor. Approximately 20% of these tumors are located in the femur. The tumor primarily occurs in children and is treated by surgical excision or radiofrequency ablation. Recently, bone-tumor resection using three-dimensional (3D) intraoperative imaging with an O-arm in combination with a navigation system has been reported to be effective. However, there is a risk of postoperative fracture because of the weakening of the bone after drilling for tumor resection. A 12-year-old Japanese girl presented with an osteoid osteoma in the left femoral shaft, which resulted in a fracture after en bloc resection and artificial bone grafting using a 3D image-guided (O-arm) assisted navigation system. Orthopedic oncologists should be aware of the risk of fracture. Moreover, they should consider the mechanical risk prediction of bone fracture using finite element analysis prior to treatment.

Osteoid Osteoma, a Diagnostic Problem: A Series of Atypical and Mimicking Presentations and Review of the Recent Literature

“…The typical radiologic sign of osteoid osteoma is a central, X-ray-permeable partially ossifying focus (nidus), surrounded by an area of reactive ossification [ 6 , 11 ]. A combination of clinical features and typical X-ray, CT, and MRI results is usually sufficient to make a reliable diagnosis [ 12 ].…”