Osteoid osteoma of the foot and ankle--A systematic review.

BACKGROUND: Osteoid osteomas are responsible for 10% of benign bone tumours. Treatment typically involves surgical excision or radio frequency ablation. The aim of this systematic review is to evaluate reported cases of foot and ankle osteoid osteomas. METHODS: We conducted a systematic review of the literature using the online databases Medline and EMBASE. We included studies reporting osteoid osteoma diagnosed either radiologically or histologically. RESULTS: 94 studies were included reporting 223 cases; 70.5% were male, mean age was 23 years, 69% reported night pain and 72% responded to NSAIDs. The commonest affected bone was the talus. CT scan was the most useful radiological investigation and MRI missed the diagnosis in 34% of cases. The majority of patients underwent surgical excision but an increasing trend of ablation therapy was demonstrated. CONCLUSIONS: A high index of suspicion based on salient history and appropriate imaging are essential for timely identification and treatment.

Talar head fracture: A case report, systematic review and suggested algorithm of treatment.

INTRODUCTION: Talar head fractures are uncommon. This rarity contributes to the lack of structure and clarity in its management. The purpose of this systematic review is to analyse the published literature on management of these injuries and suggest a treatment plan that was followed in our case. METHODS: A search of Medline, EMBASE, AMED and Google Scholar was performed on 1st September 2014. Any article reporting case(s) of talar head fractures were included and studies of other anatomical types of talar fractures, stress fractures or paediatric cases were excluded. The paucity of data precluded data synthesis and instead a narrative synthesis was performed. RESULTS: Of 45 studies identified, five publications with seven case reports met the inclusion criteria. One occurred secondary to snowboarding, one wakeboarding, one inversion injury whilst walking and one gymnastic injury. Two patients were managed operatively and two non-surgically with one requiring surgery for a symptomatic mal-union. CONCLUSION: Talar head fractures are rare and high quality literature regarding management of these injuries is lacking. A suggested algorithm for treatment is proposed, but further robust studies are required to substantiate this approach.