Hand enchondroma review of twenty five cases

ABSTRACT

Enchondroma is the most common benign bone tumor of the hand. It may present as painless swelling or after pathological fracture, and has a typical radiographic appearance. Diagnosis of benignity is proved histologically after complete removal of the tumor, and the resultant cavity is ideally filled with autologous cancellous bone. Other techniques include curettage and filling the cavity with cancellous allograft or bone substitutes, or even curettage alone. All these techniques aim to remove definitively the tumor, with less morbidity and recovery of optimal function to the hand. A series of twenty five adults is reported retrospectively, with a majority of male labourers presenting in almost all cases with painless tumors, or pathological fractures. The average age was 41 years. The middle phalanx was the most common involved site, and the diagnosis was strongly suspected with plain radiographs. Treatment consisted in immobilization, followed by tumor curettage and grafting the lacuna with autologous bone chips. No post-operative complications were recorded. The average follow-up period was 34 months. The majority of patients recovered a full active range of motion. Plain radiographs showed bone healing in all cases, and no degeneration neither recurrence was recorded. As a conclusion, the strategy consisting in tumor curettage followed by cancellous bone grafting achieved excellent clinical and radiological results: