title: A comparison of percutaneous trephine excision and open surgery in the treatment of osteoid osteoma.
abstract: The aim of this study was to compare CT-assisted percutaneous excision, which is a closed, economic method and a more cosmetic approach, and open surgery in the treatment of osteoid osteoma.
  
  
  
  Fifty-three patients (12 female and 41 male patients) who had percutaneous excision (n = 24) and open surgery (n = 29) were evaluated retrospectively. The mean age was 16.6 years and the mean duration of follow-up was 53.5 months. During percutaneous excision, a trephine was advanced through the labeling wire and the site, including the nidus, was excised en-bloc and the incision walls were curetted. During the open surgery, the localization of the nidus was marked using c-arm X-ray and the nidus was accessed by lifting the cortical bone, layer-by-layer, using burr. The nidus was excised and its cavity curetted.
  
  
  
  The result was successful in 22 and a failure in three patients who had closed excision. The result was successful in 20 and a failure in nine patients who had open surgery. The mean duration of operation was 44.37 minutes in the percutaneous excision group and 80.6 minutes in the open surgery group. There was no difference in the pre-operative VAS values between the two groups, whereas the post-operative VAS values were statistically significantly different. There was also a statistically significant difference in the duration of the operation and the length of the hospital stay between the groups.
  
  
  
  Percutaneous excision with trephine is a more successful, effective, minimally invasive, safe and a better cosmetic approach in the treatment of osteoid osteoma. This method is also a cheap method that does not require expensive equipment.
authors.affiliation: Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey. celilalemdar@mynet.com.
authors.forename: Celil
authors.initials: C
authors.lastname: Alemdar
authors.affiliation: Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Çaçan
authors.affiliation: Department of Radiology, Dicle University Medical Faculty, Diyarbakir, Turkey.
authors.forename: Abdurrahim
authors.initials: A
authors.lastname: Dusak
authors.affiliation: Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Özkul
authors.affiliation: Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Atiç
authors.affiliation: Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kapukaya
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D010017:Osteoma, Osteoid / Q000601:surgery*; D010147:Pain Measurement; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Benign tumour; Minimally invasive surgery; Osteoid osteoma; Percutaneous excision; Trephine