Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Pediatr Radiol. 2013 Jul;43(7):814-9. doi: 10.1007/s00247-013-2636-y. Epub 2013 Feb 14.
Percutaneous radiofrequency ablation (RFA) for treatment of osteoid osteoma is effective and avoids the potential complications of open surgical resection. This study evaluates the efficacy of RFA at a single tertiary-care pediatric hospital and highlights an important complication.
The medical records of 21 cases of RFA in 21 children between 2004 and 2010 were reviewed retrospectively for demographic data, lesion site, access point and technique for ablation, clinical outcome and complications.
Clinical follow-up was available for 17/21 children (81%) at an average of 17.0 months (range 0.5-86.1 months). No persistence or recurrence of pre-procedural pain was noted. Two children (9.5%) had a complication, including a burn to the local skin and muscle requiring local wound care, and a late subtrochanteric femur fracture treated successfully with open reduction internal fixation.
RFA is a safe and effective alternative to surgical resection of the osteoid osteoma nidus. When accessing the proximal femur, the risk of late post-procedural fracture must be considered and discussed with the family. An understanding of biomechanical principles in the proximal femur might provide an effective strategy for limiting this risk.
经皮射频消融（RFA）治疗骨样骨瘤是有效的，并且可以避免开放性手术切除的潜在并发症。本研究评估了单中心三级儿童医院 RFA 的疗效，并强调了一种重要的并发症。
回顾性分析了 2004 年至 2010 年间 21 例儿童共 21 例 RFA 的病历资料，以了解人口统计学数据、病变部位、消融的入路点和技术、临床结果和并发症。
17/21 例（81%）儿童获得平均 17.0 个月（0.5-86.1 个月）的临床随访。术前疼痛无持续或复发。2 例（9.5%）患儿出现并发症，包括局部皮肤和肌肉灼伤，需局部伤口护理，以及晚期转子下股骨骨折，经切开复位内固定成功治疗。
RFA 是手术切除骨样骨瘤病灶的安全有效替代方法。当涉及到股骨近端时，必须考虑并与家属讨论术后晚期骨折的风险。了解股骨近端的生物力学原理可能为限制这种风险提供有效的策略。
