J Korean Orthop Assoc.  2016 Feb;51(1):85-90. 10.4055/jkoa.2016.51.1.85.

Clinical and Radiographic Outcomes of Simple Curettage and Graft Using Allogenic Bone or Bone Substitute for Enchondroma Involving Short Tubular Bone of the Hand and Foot

• Bahk WJ
• Kim NH
• Park KS
• Kim JY

• KMID: 2154353
• DOI: http://doi.org/10.4055/jkoa.2016.51.1.85

Abstract

PURPOSE
We analyzed outcomes after management of enchondroma involving short tubular bones of the hand and foot by curettage and grafting using allogenic bone or bone substitutes.
MATERIALS AND METHODS
Twenty-two patients (allogenic bone 15 and bone substitutes 7 patients) were recruited. Clinical results were assessed by pain, cosmetic problem, range of motion of joint and the power of grasp. Radiographic outcomes were analyzed by degree of bone defect.
RESULTS
Clinically, 19 patients were classified as excellent and 3 patients as good. Three patients with K-wire fixation had pain with local irritation, which was easily controlled by removal of the K-wires. There were no complications including deep infection, delayed or nonunion, refracture. Radiographically, 20 cases were classified as group 1 (bone defect smaller than 3 mm) and the 2 remaining cases were classified as group 2 (bone defect 4-10 mm).
CONCLUSION
Curettage and graft using allogenic bone or bone substitute is an effective modality of treatment for enchondroma involving short tubular bones of the hand and foot. When combined with pathologic fracture, early surgical management could shorten duration of immobilization. Surgical management might be considered for the lesion involving the foot when discovered because of high incidence of pathologic fracture.

Keyword

enchondroma; allogenic bone; bone substitutes; hand and foot

MeSH Terms

Bone Substitutes*
Chondroma*
Curettage*
Foot*
Fractures, Spontaneous
Hand Strength
Hand*
Humans
Immobilization
Incidence
Joints
Range of Motion, Articular
Transplants*
Bone Substitutes

Figure

• 

  Figure 1 Anatomic distribution of enchondromas in the hand and feet.

• 

  Figure 2 (A) Preoperative radiograph in a 37-year-old female shows a ballooning lytic lesion with intralesional calcification involving almost the entire 5th metacarpal bone. (B) Immediate postoperative radiograph demonstrates a lesion filled with allograft bone and fixed with K-wires. (C) A radiograph at 36 months after surgery shows a tiny defect less than 3 mm with normal cortex (group 1).

• 

  Figure 3 (A) Preoperative radiograph in a 21-year-old female shows a lytic lesion and intralesional calcification in association with a pathologic fracture involving 3/4 of the proximal phalanx of the middle finger. (B) Immediate postoperative radiograph shows a lesion filled with synthetic bone material (calcium phosphate) and fixed with K-wires. (C) A radiograph at 14 months after surgery shows no defect with normal cortex (group 1).

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