Abstract
Introduction: The most typical primary bone tumour of the hand is an enchondroma. A pathologic fracture is a common presentation of this benign cartilaginous tumour. It is common for asymptomatic solitary enchondromas to be discovered during regular x-rays. However, in nearly half of the cases, acute pain, swelling, and deformity indicate a pathologic fracture. For symptomatic lesions, surgical therapy with curettage and bone graft is the norm. Case Presentation: A 15-year-old girl with chief complain of pain on her right little finger and history of trauma after playing basketball 5 days before admission. At inspection, the fifth finger was painful during movement, with a discrete residual hematoma around the proximal phalanx. The x-rays showed a minimally displaced fracture at the shaft of the proximal phalanx of the 5th finger of the right hand, and lytic lesion occupying the whole middle third of the phalanx. We assessed the patient with pathological fracture suggestive of an enchondroma. A 1-stage surgical treatment was decided: a curettage followed by open reduction internal fixation using miniplate titanium matrix, and bone graft to fill the defect. Postoperative x-rays showed complete healing of the fracture at 4 weeks. Conclusion: Enchondromas pose the risk of pathological fracture, recurrence and, to a lesser extent, malign transformation. We describe an option of surgical management which is simple and results in good and excellent short-term results. Successful treatment of these lesions is dependent on the complete removal of the tumour bed followed by stabilization.
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