Osteoid osteomas of the foot and ankle: a study of patients over a 20-year period.

Osteoid osteomas (OOs) are common benign bone tumors that seldom occur in the foot or ankle. Patients typically complain of pain that is worse at night and is relieved with use of nonsteroidal anti-inflammatory drugs. Previous studies of treating these lesions in the foot and ankle have been limited to case reports. We retrospectively reviewed all cases of a histologically confirmed foot or ankle OO treated surgically or with an interventional radiologic procedure between 1990 and 2010. Thirteen (12 male, 1 female) patients had a foot or ankle OO. The most common site was the talus (n=5). Ten lesions were treated surgically, 3 with radiofrequency ablation (RFA). Surgical patients required 3 weeks of restricted weight-bearing, whereas patients treated with RFA had no weight-bearing restrictions. At final follow-up, all patients reported complete pain relief and return to previous activities. Surgical curettage and RFA provided excellent symptom relief in patients with a foot or ankle OO. We recommend RFA for lesions with diagnostic imaging. RFA is contraindicated for lesions near a major neurovascular bundle. Surgeons should carefully measure the distance from lesion to articular cartilage and use the treatment that minimizes damage to the cartilage.