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Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus Following Fibular Graft Harvest in Children: A Series of 15 Patients

Volume 7 | Issue 3 | September-December 2021 | Page: 17-22 | Ankit Jain, Anil Agarwal, Nitish Bikram Deo, Ankur, Jatin Raj Sareen DOI-10.13107/ijpo.2021.v07i03.117 Authors: Ankit Jain D. Ortho. [1], Anil Agarwal MS Ortho. [1], Nitish Bikram Deo MS Ortho. [1], Ankur MS Ortho. [1], Jatin Raj Sareen MS Ortho. [1] [1] Department of Paediatric Orthopaedics, Chacha […]

Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

Volume 7 | Issue 3 | September-December 2021 | Page: 13-16 | Sandeep Patwardhan, Arkesh Madegowda, Ashok Shyam, Parag Sancheti DOI-10.13107/ijpo.2021.v07i03.116 Authors: Sandeep Patwardhan MS Ortho. [1], Arkesh Madegowda MS Ortho. [1], Ashok Shyam MS Ortho. [1, 2], Parag Sancheti MS Ortho. [1] [1] Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India. […]

Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus Following Fibular Graft Harvest in Children: A Series of 15 Patients

Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

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Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus Following Fibular Graft Harvest in Children: A Series of 15 Patients

Volume 7 | Issue 3 | September-December 2021 | Page: 17-22 | Ankit Jain, Anil Agarwal, Nitish Bikram Deo, Ankur, Jatin Raj Sareen

DOI-10.13107/ijpo.2021.v07i03.117

Authors: Ankit Jain D. Ortho. [1], Anil Agarwal MS Ortho. [1], Nitish Bikram Deo MS Ortho. [1], Ankur MS Ortho. [1], Jatin Raj Sareen MS Ortho. [1]

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Delhi, India.

Address of Correspondence
Dr Anil Agarwal
Specialist, Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Delhi, India.
E-mail: anilrachna@gmail.com

Abstract

Purpose: To assess the role of temporary transphyseal medial malleolar screw hemiepiphysiodesis in cases of acquired ankle valgus following non-vascularized fibular harvest.
Methods: This retrospective chart review included 15 children (18 ankles). Exclusion criteria were inadequate records or additional procedures besides screw hemiepiphysiodesis. Radiological evaluations included lateral distal tibial angle (LDTA) and fibular station (Malhotra grade).
Results : The average patient age was 8.6 years at surgery. The overall duration of treatment was 18.2 months and post removal follow-up (5 ankles) was 16.6 months. The average correction rate was 0.48 degrees/ month. LDTA changed significantly following hemiepiphysiodesis (Pre-op 077.3 degrees/ in situ follow-up 85.9 degrees). The Malhotra grade did not change significantly during the same period. The average recurrence rate [noted in 4/5 patients] was 0.52 degrees per month. However, LDTA and Malhotra grade did not change significantly post removal.
Conclusions : We report the results of temporary transphyseal medial malleolar screw hemiepiphysiodesis for post fibular harvest acquired ankle valgus in children. Temporary hemiepiphysiodesis is a viable option for the correction of acquired ankle valgus in children. The fibular station is however not restored following the procedure. Recurrence of deformity following screw removal remains a worrying complication in some patients.
Keywords: Hemiepiphysiodesis, Ankle valgus, Growth modulation, Fibula, Harvest

References

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How to Cite this Article: Jain A, Agarwal A, Deo NB, Ankur, Sareen JR | Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus following Fibular Graft Harvest in Children: A Series of 15 Patients | International Journal of Paediatric Orthopaedics | September-December 2021; 7(3): 17-22.

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Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

Volume 7 | Issue 3 | September-December 2021 | Page: 13-16 | Sandeep Patwardhan, Arkesh Madegowda, Ashok Shyam, Parag Sancheti

DOI-10.13107/ijpo.2021.v07i03.116

Authors: Sandeep Patwardhan MS Ortho. [1], Arkesh Madegowda MS Ortho. [1], Ashok Shyam MS Ortho. [1, 2], Parag Sancheti MS Ortho. [1]

[1] Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
[2] Department of Research, Indian Orthopaedic Research Group, Thane (W), Maharashtra, India.

Address of Correspondence
Dr Arkesh Madegowda
Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
E-mail: dr.arkesh@gmail.com

Abstract

Background and purpose: Osteoid osteoma (OO) constitutes 10-12% of all benign bone tumours making it one of the most commonly occurring bone tumour. Radiofrequency ablation (RFA) offers a minimally invasive day care treatment option where in the tumour cells in the nidus are thermo-coagulated. The purpose of this study is to highlight the diagnostic protocol of OO and evaluate the safety and efficacy of RFA in its treatment.
Methods: A total of 36 patients (26 male, 10 female patients; mean age 10.33 years; age range 4-20 years) who underwent Computerized tomography (CT) guided RFA treatment for osteoid osteoma of various anatomical locations were included in this study. Patients underwent radiography and CT evaluation for diagnosis. When classical symptoms were absent and CT was inconclusive, patients underwent further evaluation with magnetic resonance imaging (MR) and nuclear scan. Features suggestive of OO in any two of these investigations was considered confirmatory and such patients were offered RFA. Patients were assessed for abolition of pain after treatment and complications if any were recorded.
Results: The intra nidus location of probe which was considered as technical success was noted in all patients. There was significant improvement in pain after RFA. Visual Analogue Scale (VAS) score improved from 7.2 preoperatively to 0.6 and 0.0 at 3 months and 6 months respectively. Two patients of tibia OO had superficial skin burns that healed within 2 weeks. One patient sustained tibia fracture at RFA site after a fall and but was pain free after 20 weeks. At the latest follow up of 28 months (range 14-56 months), there were no recurrences.
Conclusion: Diagnosis of osteoid osteoma may be challenging at times and additional investigations like MRI/nuclear bone scan along with radiography and CT aid in making an appropriate diagnosis. CT guided radiofrequency ablation of osteoid osteoma is a safe, effective and minimally invasive treatment modality with low complication rates.
Keywords: Osteoid osteoma, Computed tomography guided, Radiofrequency ablation, Minimally invasive, Day care.

References

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How to Cite this Article: Patwardhan S, Madegowda A, Shyam A, Sancheti P | Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography- Guided Radio Frequency Ablation in a Series of 36 Patients | International Journal of Paediatric Orthopaedics | September- December 2021; 7(3): 13-16.

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Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus Following Fibular Graft Harvest in Children: A Series of 15 Patients

Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus Following Fibular Graft Harvest in Children: A Series of 15 Patients

Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

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Temporary Transphyseal Medial Malleolar Screw Hemiepiphysiodesis for Acquired Ankle Valgus Following Fibular Graft Harvest in Children: A Series of 15 Patients

Authors: Ankit Jain D. Ortho. [1], Anil Agarwal MS Ortho. [1], Nitish Bikram Deo MS Ortho. [1], Ankur MS Ortho. [1], Jatin Raj Sareen MS Ortho. [1]

Abstract

(Article Text HTML) (Full Text PDF)

Osteoid Osteoma; A Diagnostic Protocol and Treatment with Computed Tomography Guided Radio Frequency Ablation in a Series of 36 Patients.

Authors: Sandeep Patwardhan MS Ortho. [1], Arkesh Madegowda MS Ortho. [1], Ashok Shyam MS Ortho. [1, 2], Parag Sancheti MS Ortho. [1]

Abstract

(Article Text HTML) (Full Text PDF)

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