Pathologic Femur Fracture through Osteoid Osteoma after Radiofrequency Ablation: Case Report and Review of the Literature

Abstract

This is a case report of a 4-year-old girl who sustained a femoral shaft fracture 2 weeks after radiofrequency ablation of an osteoid osteoma. The fracture occurred after a relatively low-energy impact, jumping off the second to last step of a staircase. The pathologic fracture was successfully treated with closed reduction and spica casting, with full return to activities. Cases have been reported in the literature of femoral shaft fractures in older patients after radiofrequency ablation, but all are farther out than 2 weeks and none in patients as young as 4 years.

Figure 1

Left femur fracture around prior osteoid osteoma. The patient was 2 weeks s/p RFA of her OO.

Figure 2

X-ray and CT images of OO 3 months prior to fracture, 2.5 months prior to RFA.

Figure 3

Intraoperative fluoroscopy after closed reduction and spica cast application.

Figure 4

Healing X-rays from clinic 5 weeks after spica cast application.

Figure 5

Healed X-rays from clinic 10 weeks after spica casting.