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Osteoid osteoma is a benign tumor originating from osteoblasts, and it is mostly seen in long bones of lower limbs. The distal phalanx of the foot is an atypical location for an osteoid osteoma, and lesions occurring in this location may be a diagnostic challenge. A 22-year-old man presented with a complaint of severe pain on the second distal phalanx of his right foot. An osteoid osteoma was suspected after radiologic evaluation. The lesion was surgically excised and removed completely by curettage. Histopathologic evaluation confirmed the diagnosis of an osteoid osteoma. The patient was followed-up for a 9-month period without any symptoms or recurrence.

Osteosarcoma is a rare disease characterized by the production of tumoral osteoid or immature bone after the proliferation of malignant osteoblasts. [1] Treatment of osteosarcoma is primarily based on neoadjuvant and adjuvant chemotherapy (CT) and surgical resection. With developments over the years, the combined use of surgical treatment and CT has significantly increased the cure and survival rates of patients. [2] Although multimodal therapy has greatly improved patients' oncological outcomes, the prognosis of metastatic or recurrent osteosarcoma is still unsatisfactory.Although many prognostic factors affecting the course of the disease have been described in the literature, controversial results have been reported.Objectives: This study aims to examine the clinical results of patients who underwent medical and surgical treatment for osteosarcoma, to determine the overall survival (OS) and disease-free survival (DFS) rates, and to examine the effects of prognostic factors on these rates. Patients and methods: Between January 2005 and January 2020, a total of 64 patients (38 males, 26 females; mean age: 20.9±11.5 years; range, 6 to 70 years) who received medical and surgical treatment for osteosarcoma were retrospectively analyzed. Demographic characteristics, follow-up period, tumor location and size, tumor stage and necrosis rate, metastatic disease, surgical treatments, postoperative complications, local recurrence, and metastasis were recorded. The relationship of these factors with the survival was examined. Results: The median follow-up was 51.6 (range, 3 to 156) months. The most common tumor localization was in the distal femur with 42 (65.6%) patients and the most common histopathological subtypes were conventional osteosarcoma in 50 (78.1%) patients. The OS rates were 91.6% at one year, 65.9% at five years, and 51.6% at 10 years. With the exception of two patients who died during neoadjuvant chemotherapy, all patients underwent surgical treatment. The addition of chemotherapy + radiotherapy in the treatment did not provide any benefits in terms of survival and recurrence compared to the group that was not added, and the five-year OS rate was 79.3% compared to 20.7%, respectively. The overall 10-year survival rates were 83.9% and 37.2% in the group with a good response (≥90%) and poor response (<90%) to treatment (p=0.012). The mean survival time of three patients who presented with pathological fractures was shorter than the others (p>0.05). Surgical margin was ≤2 mm in 27 (42.2%) patients, >2 mm in 30 (46.9%) patients, and surgical margin was positive in five (7.8%) patients. The mean OS in the group with a surgical margin closure of >2 mm was 10.8±1.9 years and was longer than the other groups (p=0.047). Conclusion: Metastasis at the time of diagnosis, <90% tumor necrosis, a tumor size of ≥10 cm, and metastasis development were significantly associated with poor survival and were found to be independent prognostic factors. The OS rate in the patient group with Stage III-IV response after neoadjuvant...

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An osteochondroma or exostosis is the most common benign bone tumor, and it is commonly localized in the metaphyses of the long tubular bones. Lesions are rarely localized around the ankle. We present a case series with osteochondroma around the ankle. All of the patients presented with a mass around the ankle. In these three cases, the masses were symptomatic, and in one patient it caused a deformity. Osteochondroma was suspected after physical examination and radiologic evaluation. After preoperative work-up, diagnosis, and exhaustion of conservative care, a plan for surgical excision was presented to each patient. Histopathologic evaluations confirmed the diagnosis of osteochondroma. The patients have been discharged without any complications or symptoms during clinical follow-up.

The aim of this study is to evaluate sur ger y per for med due to acute Achilles tendon r uptur e in the light of the subjective and objective data obtained from isokinetic muscle strength measurements. The study included 25 patients with acute achilles tendon rupture. The surgical outcomes were evaluated with the AOFAS foot and hindfoot evaluation score, and the data obtained with the Cybex isokinetic dynamometer. The mean AOFAS foot and hindfoot evaluation score was 98.4 ± 3.7. In the scoring system developed by Thermann et al., the mean value was 89.2 ± 6.8. Accordingly, 13 (52%) of the patients had excellent, 11 (44%) good and 1 (4%) moderate results. In the subjective evaluation, 21 (84%) of the cases were evaluated as excellent, 3 (12%) as good and 1 (4%) as fair. Calf circumference was measured as mean 38.8 ± 3.7 cm on the operated side and 39.8 ± 3.4 cm on the contralateral side, and the difference was not considered statistically significant (p˃0.05). In the measurements made with the isokinetic dynamometer, no significant difference was determined between the healthy and operated sides in respect of the 30°/sec plantar flexion-dorsiflexion peak torque, 120°/sec plantar flexion peak torque and total work measurements (p >0.05). The 120°/sec dorsiflexion peak torque value was found to be statistically significantly higher in the operated ankle (p˂0.05). Although there is no consensus about the treatment protocol for achilles tendon ruptures to be selected, considering the patient profile, methods that allow early active movement, shorten the immobilization period, minimize the loss of work force, and increase patient satisfaction with a low complication rate should be chosen. In this respect, open surgical procedures can be considered the most suitable treatment method for achilles tendon ruptures.

Chondroblastoma is a sporadic benign bone tumor originating from cartilage cells. Chondroblastoma was first accepted as an entity by Kolodny [1] in 1927 and was defined as a "giant cell variant". The term chondroblastoma was introduced by Jaffe and Lichtenstein [2] in 1942 and was included in the group of chondroid tumors by distinguishing it from giant cell tumors. It accounts for less than 1% of all bone tumors and 9% of benign bone tumors. [3] Chondroblastoma is mostly located in the epiphyses of long bones, with the most common localizations being the proximal humerus, distal femur, proximal femur, and proximal tibia. [4] It is very rare to be seen over the age of Objectives: This study aims to investigate the effect of adjuvant cryotherapy added to well-performed high-speed burr curettage on the long-term surgical outcomes of chondroblastoma cases.Patients and methods: Between January 2004 and December 2020, a total of 30 chondroblastoma cases (19 males, 11 females; median age: 18.6 years; range, 9 to 53 years) who were surgically treated were retrospectively analyzed. The pressurized-spray technique was performed using liquid nitrogen. Data including age, sex, radiological appearance, treatment modality, duration of follow-up, skin problems, and recurrence were recorded. All patients received adjuvant liquid nitrogen cryotherapy after extended intralesional curettage with high-speed burr. The bone cavity was filled with an autologous iliac crest bone graft, allograft, or polymethylmethacrylate (PMMA). Results:The median follow-up was 54 (range, 19 to 120) months. The lesion was located around the knee in 16 (53.3%), in the shoulder in seven (23.3%), around the hip in five (16.6%), and in the ankle in two (6.6%) cases. The defect was filled with an autologous iliac crest bone graft in 28 (93.3%), an additional allograft in eight (26.7%), and PMMA in two (6.7%) cases. Local recurrence was observed in only two (6.7%) patients during follow-up. Two (6.7%) patients developed physeal growth arrest. Osteoarthritic changes were observed in two (6.7%) patients (one knee and one hip) due to the periarticular location of the tumor. Three (10%) patients had skin complications. None of the cases had a pathological fracture. Conclusion:A well-performed extended intralesional curettage with high-speed burr is the first and essential step in treating chondroblastoma. Adding adjuvant liquid nitrogen cryotherapy with high-speed burr can improve treatment outcomes and significantly reduce the recurrence rate of this disease.