Surgical Treatment of Solitary Enchondromas of the Hand.

Sercan Çapkin,Kutay Yilmaz,Ali Cavit,Tufan Kaleli

doi:10.7759/cureus.7497

Abstract

Objective: The present retrospective study evaluated the clinical and radiologic results of patients who underwent complete curettage and autologous bone grafting for hand-located isolated enchondromas with a minimum follow-up period of one year.Patients and Methods: Thirty-two patients with a follow-up period of at least 12 months who underwent operation between August 2010 and October 2018 due to the presence of solitary enchondroma of the hand were included in the study. All patients underwent complete curettage and filling of the defect via autologous bone grafting. Autologous bone graft was harvested from the iliac crest and distal radius in 24 and eight patients, respectively. The patients underwent radiography on the first postoperative visit and at six weeks, 12 weeks, and annually. The range of movement of the finger joint was evaluated by comparing it with the healthy contralateral side. Functional outcomes and radiologic outcomes were evaluated. The frequency of complications and recurrences were established.Results: Twelve patients were male and 20 were female. The average age was 34 (range: 16-56) years. The most common digit involved was the little finger (nine cases, 28.125%); the proximal phalanx was the most common location (17 cases, 53.125%). Control radiography in the sixth week revealed graft consolidation in all patients. No case of nonunion or recurrence was detected clinically or radiologically, with a mean follow-up period of 54 (range: 12-96) months. Functional outcomes were classified as excellent in 28 patients and as good in four patients. The final radiographic appearances included Tordai’s group 1 in 28 bones and group 2 in four bones. Conclusion: Curettage and autologous bone grafting are safe, costless, and effective treatment options for hand enchondroma, with satisfactory functional and radiographic outcomes. Harvesting bone graft from the distal radius provides a shorter length of hospital stay and lower complication rates compared to obtaining the graft from the iliac crest.

Highlights

Enchondromas are benign cartilaginous tumors comprising mature hyaline cartilage and are the most common primary osseous tumors of the hand [1,2,3,4,5,6]
The present retrospective study evaluated the clinical and radiologic results of patients who underwent complete curettage and autologous bone grafting for hand-located isolated enchondromas with a minimum follow-up period of one year
Autologous bone graft was harvested from the iliac crest and distal radius in 24 and eight patients, respectively

Summary

Introduction

Enchondromas are benign cartilaginous tumors comprising mature hyaline cartilage and are the most common primary osseous tumors of the hand [1,2,3,4,5,6]. They are often solitary lesions in the phalanges. The malignant transformation of a solitary enchondroma into chondrosarcoma is exceedingly rare [7]. They may rarely present as multiple lesions. Proximal phalanges are the most frequently affected part of the hand, followed by the middle phalanges, metacarpals, and rarely distal phalanges [9,10]

Methods

Results

Conclusion