osteoblastoma is a rare ( incidence < 1% ) benign locally aggressive osteoblastic lesion of bone with rare malignant transformation .
benign osteoblastoma is the term used by jaffe to denote an uncommon neoplasm of bone characterized by vascular osteoid and bone forming matrix rich in osteoblasts .
here we report a case of osteoblastoma of talus in eighteen year old male patient from bijapur with complaints of pain and difficulty in walking for one year .
it was treated with wide excision and bone grafting from ipsilateral ilium and talo - navicular fusion with cannulated cancellous screw fixation .
patient was immobilized with below knee plaster cast for six weeks later with gradual mobilization .
osteoblastoma of talus is a rare benign tumor , if suspected surgical wide excision and talo - navicular fusion with cannulated cancellous screw fixation , with bone grafting is the better treatment of choice .
osteoblastoma is a rare bone - forming neoplasm that represents less than 1% of bone tumors in the mayo clinic series .
benign osteoblastoma is the term used by jaffe to denote an uncommon neoplasm of bone characterized by vascular osteoid and bone - forming matrix rich in osteoblasts .
osteoblastoma is a benign bone tumour found commonly in the spine and long tubular bones .
involvement of the talus is uncommon , and when present , is found in the neck of the talus . with respect to age , the incidence appears to be highest in the second decade of life [ 4 , 1 ] .
the tumour usually is slow growing , and symptoms may be present for 1 to 2 years before a diagnosis is made .
radiologically , osteoblastoma is a lytic lesion originating in the medulla of bones with matrix ossification and mild surrounding sclerosis .
the lesion can be removed with intralesional curettage or wide resection , depending on the clinical situation , location within the bone and suspicion of malignancy .
recurrence rates vary with the surgical approach and wide resection is associated with lower recurrence rates .
the purpose here is to report this kind of rare case treated with wide resection and bone grafting with talo - navicular arthrodesis for satisfactory outcome .
an eighteen years old male patient , from bijapur , came with complaints of pain in right ankle , difficulty in walking since one year .
pain was insidious in onset , gradually progressing , intermittent , aggravates with walking and movements of ankle and foot , relieves with analgesic medication .
radiology of ankle anteroposterior and lateral views showed an expanded lytic lesion around 23 cm in talar neck body junction , involving articular cartilage , with thin shell of periosteal bone , clear zone of transition and sclerotic rim [ fig-1 ] . on the basis of clinical and x - ray features provisional diagnosis of osteoblastoma is done .
the patient was planned for wide excision biopsy , bone grafting from ipsilateral ilium and talo - navicular fusion with cannulated cancellous screw fixation [ fig-2 , 3 ] .
biopsy material sent for histopathology and report showed irregular spicules of mineralized bone and eosinophilic osteoid rimmed by osteoblasts .
the tumor cells differentiate into osteoblasts which make varying amounts of osteoid and woven bone confirming osteoblastoma talus [ fig-4 ] .
post operatively , below knee cast was applied with non - weight bear mobilisation for six weeks [ fig-5 ] .
ankle , subtalar joint active and passive movements were also carried out [ fig-7 , 8 , 9 , 10 ] .
patient attained full weight bear painless unaided mobilisation with satisfactory ankle and subtalar movements at the end of six months .
in 1932 , jaffe and mayer presented a comprehensive report of a metacarpal bone with osteoid and bone forming tumor .
lichtenstein , in 1952 , used the name osteogenic fibroma to denote a group of tumors with active osseous proliferation in a highly vascular connective - tissue stroma in which there was osteoclastic resorption and remodelling . in 1954 , golding and sissons reported two instances of osteogenic fibroma which involved the vertebral column .
jaffe , in 1956 , in a comprehensive review objected to the name osteogenic fibroma and advocated the use of the name benign osteoblastoma which later got accepted .
with respect to age , like in our case , osteoblastoma typically presents during the second decade of life , although cases have been reported in both younger and older patients .
. the pain increases in severity with time and has an unpredictable response to anti - inflammatory agents .
et al , in their seven case series study of osteoblastoma of the talus reported that all the patients had symptoms of one year duration or longer , with pain in and around talus not particularly increases at night .
osteoid - osteoma and osteoblastoma are considered as variant of the same pathologic process and hence for radiological diagnosis diameter more than 2 cm is considered as osteoblastoma .
nicholas and jack concluded that , it seems virtually impossible to diagnose benign osteoblastoma without benefit of histopathological studies of the material .
a case report by nicholas and jack found that curettement of small to moderate lesions followed by packing of the defect with bone chips seems to be the treatment of choice .
removal of a wide margin of normal bone does not seem to be necessary , although complete excision , when surgically feasible and technically easy , seems also to yield good results and is not contra - indicated . in their twenty case series of osteoblastoma ,
yener saglik et al foundthat there were no recurrences in the patients who were treated with wide resection of the tumour .
recurrence was observed in one of six patients who underwent marginal excision , and in two of eleven patients who underwent intralesional curettage .
they concluded that in the treatment of patients with osteoblastoma , wide resection should be considered whenever it is anatomically possible . according to carol det al , neither malignant transformation nor metastases of these lesions
recurrence following incomplete intralesional curettage occurs in up to 15% . considering these in our case ,
wide excision of the tumor was done and later gap was filled with bone graft and skeletal stabilisation was performed with talo - navicular arthrodesis with cannulated cancellous screw fixation . the resected part was sent for histopathological examination for the confirmation of the diagnosis . even though the screw used for the fixation
is little longer and violating the navicular - cuneiform joint , patient is not complaining of any discomfort or pain .
most authors do not recommend radiation treatment unless absolutely necessary for symptomatic inoperable lesions like in spine .
moreoversarcomatous degeneration has been reported and may be more common in lesions previously treated with radiation
osteoblastoma of the talus is a rare benign tumour occurring mainly in the second decade of life , presents with constant pain in and around talus .
whenever it is suspected and anatomically possible , wide resection with reconstruction to be done for the successful outcome and the condition can be confirmed only by histopathological examination of the material .
though rare , osteoblastoma of talus has to be considered when an osteolytic lesion with more than 2 cm diameter in second to third decade of life .
 introduction : osteoblastoma is a rare ( incidence < 1% ) benign locally aggressive osteoblastic lesion of bone with rare malignant transformation . 
 benign osteoblastoma is the term used by jaffe to denote an uncommon neoplasm of bone characterized by vascular osteoid and bone forming matrix rich in osteoblasts.case report : here we report a case of osteoblastoma of talus in eighteen year old male patient from bijapur with complaints of pain and difficulty in walking for one year . 
 relevant investigations and radiographs were taken . 
 it was treated with wide excision and bone grafting from ipsilateral ilium and talo - navicular fusion with cannulated cancellous screw fixation . 
 histopathology of the biopsy confirmed the diagnosis . 
 patient was immobilized with below knee plaster cast for six weeks later with gradual mobilization . 
 guarded weight bear was allowed after three months . 
 patient achieved satisfactory range of movements and full weight bear mobilization after six months . 
 symptoms relieved with no evidence of any recurrence in one year follow up.conclusion:osteoblastoma of talus is a rare benign tumor , if suspected surgical wide excision and talo - navicular fusion with cannulated cancellous screw fixation , with bone grafting is the better treatment of choice . the condition can only be confirmed after histopathological examination . 
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Introduction
Case Report
Discussion
Conclusion