Background: Osteoid osteoma is a well-known benign tumor of bone. It occurs in children and young adults and is rarely seen above the age of 40. It is uncommon in hand and wrist. If it occurs in hand and wrist, its diagnosis is difficult because of its unusual presentations both clinically and radiologically.

Materials and Methods: We encountered ten patients with osteoid osteoma of hand during the last ten years in orthopedic department of Emam university hospital from 1970 to 1979.

Results: The average age of ten patients with osteoid osteoma of the hand and wrist that were treated in Imam hospital from 1369 to 1378, was 22.9 years (range, 14 to 33 years). Five lesions were in proximal phalanx, one in middle phalanx, and one in distal phalanx. In the wrist, one lesion was in the capitate, one in the lunate, and one in the hamate. The average time from onset of symptoms to successful treatment was 20 months (range, 4 months to 60 months). Three of ten patients had had treatment elsewhere, all of them had had unsuccessful operative procedures related to incorrect diagnosis. All patients had a minimum follow-up of 6 months (range, 6 months to 9 years, mean: 4.6 years). The operative treatment were successful in all ten patients without any signs or symptoms of recurrence. Only limitation of proximal interphalangeal joint range of motion was remained in one patient due to 60 months delay in diagnosis and treatment.

Conclusion: High index of suspicion is necessary for diagnosis of osteoid osteoma of hand because of unusual presentation of it. The most important factors for successful treatment of osteoid osteoma of hand are accurate diagnosis and exact preoperative planning.