Is the Treatment of Enchondroma in the Hand by Simple Curettage a Rewarding Method?

Tordai, P; Höglund, Margaretha; H, Lugnegård

doi:10.1016/0266-7681_90_90013-t

Cited by 29 publications

(11 citation statements)

References 11 publications

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“…Radiographic consolidation was defined by the presence of normal cortical bone and if the bone defect was less than 3 mm on plain radiographs after surgery. This finding corresponds to grade I of Tordai classification 34 (grade I, normal cortical bone or a bone defect smaller than 3 mm in diameter; grade II, bone defects with a diameter 4 to 10 mm; grade III, bone defect larger than 10 mm with characteristics of enchondroma). We reviewed the duration of consolidation and analyzed the difference in duration according to the Takigawa classification of the lesion.…”

Section: Methodssupporting

confidence: 69%

Simple curettage and allogeneic cancellous bone chip impaction grafting in solitary enchondroma of the short tubular bones of the hand

Park

Joo

Choi

et al. 2023

Sci Rep

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Enchondroma is the most common bone tumor in the hand. While standard surgical procedure is intra-lesional excision and bone grafting, there is a dispute between allogeneic bone, autogenous bone, and synthetic bone substitute grafting. Diverse adjuvant treatments have been introduced to reduce recurrence, but results are mixed with controversies. Meanwhile, whether existing descriptive classification could predict treatment outcome remains unclear. Thus, we reviewed patients with solitary enchondroma of the hand who underwent simple curettage followed by allogeneic cancellous bone chip impaction grafting. Eighty-eight patients with more than 5 years of follow-up were enrolled. Demographic data, local recurrence, and complications were reviewed. Duration of consolidation and the difference according to Takigawa classification were assessed. Range of motion (ROM), and functional scores were also evaluated. There were 51 women and 37 men, with a mean age of 37.9 years. Mean follow-up was 10.2 years. Recurrence occurred only in one patient. There was no complication. Mean postoperative total active motions of fingers and thumb were 239° and 132.9°. Mean modified Disabilities of the Arm, Shoulder, Hand score, and Musculoskeletal Tumor Society Score were 1.63, and 99.2 at the last follow-up. Consolidation, ROM, and functional scores according to Takigawa classification showed no significant differences. This study suggests that simple curettage with impaction grafting of allogeneic cancellous bone chip is a feasible method for treating solitary enchondromas involving short tubular bone of the hand with good long-term outcomes. Postoperative recurrence and complication rates were very low. Radiographic and clinical results were good regardless of the previous radiological classification.

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Section: Methodssupporting

confidence: 69%

Simple curettage and allogeneic cancellous bone chip impaction grafting in solitary enchondroma of the short tubular bones of the hand

Park

Joo

Choi

et al. 2023

Sci Rep

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“…Treatment of enchondromas of the hand was initially reported as a plan with curettage alone. However, placing a bone substitute into the created cavity has become popular, although it has remained a debatable topic [4][5][6][7][8][9][10][11] . We put a bone substitute in the cavity in patients, and we believe that such an approach would be more reliable, considering that the consolidation period is not long, which will pose a risk in terms of fractures and deformities that may occur after the cavitary wall is thin in patients.…”

Section: Discussionmentioning

confidence: 99%

“…Confirming histopathological diagnosis, 2. Eliminating the risk of fracture, and 3. preventing the progression of the deformity 4 . Previously, only curettage was recommended for treatment [5][6] .…”

Section: Introductionmentioning

confidence: 99%

“…Afterward, it was suggested that the cavity formed after curettage should be filled by the bone substitute [7][8] . Theoretically, the accumulation of osteoprogenitor cells in this region by hematoma due to iatrogenic fracture after curettage and new bone may make this approach rational 4 . However, the weakness of the bone and the time it takes to heal have made it attractive to use bone substitutes to increase mechanical support 9 .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of risk factors for recurrence in hand enchondromas, the effect of pathological fracture and graft selection on clinical results

Mirioğlu

KIRAN

KUNDAKÇI

et al. 2022

JoCASS

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Amaç: Enkondrom, falanks ve metakarpusun en sık görülen tümörüdür. Çeşitli teknikler ve yöntemler uzun süredir araştırılmaktadır. Enkondromlu geniş bir hasta yelpazesinde yapılan küretaj ve kullanılan kemik greftinin klinik ve radyolojik sonuçlarını incelemeyi amaçladık. Yöntem: Çalışmaya enkondrom tanısı ile ameliyat edilen 47 hasta dahil edildi. Küretaj sonrası oluşan kavite kemik greftleri ile dolduruldu. Hastaların ortalama yaşı 29.32±15.08 yıl, takip süresi 28.47±25.10 aydı. Standart takip protokolüne uymayan hastalar çalışma dışı bırakıldı. Deneyimli bir ortopedik cerrah radyolojik sonuçları değerlendirdi ve nüksleri olan hastalar için MRG görüntüleri ve raporları hastane veri tabanından alındı. Eklem hareket açıklığı ve gözlenen deformiteye göre klinik değerlendirme yapıldı. Bulgular: Ortalama konsolidasyon süresi 3.08±2.19 aydı. Nüks oranı %6.4’tü. Kırık ile ya da kırıksız başvuran gruplar arasında, allogreft ve otogreft grubu arasında klinik ve radyolojik sonuçlar açısından fark yoktu. Sonuç: Küretaj ve greftleme, enkondrom için hala güncel ve güvenilir bir yöntemdir.

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“…10 However, recently, questions have been raised regarding whether bone grafting is necessary at all, or whether similar results can be obtained through the use of autograft or bone substitutes without the need for bone graft donor-site surgery. [11][12][13] Despite several of these articles concluding that grafting is not necessary, others continue to advocate the use of grafting for these defects. The question of to graft or not to graft these defects remains contentious.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Enchondromas of the Hand: A 12-Year Experience

Redgrave

Nikkhah

Kang

et al. 2023

Journal of Hand and Microsurgery

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Objective Enchondromas are benign tumours of hyaline cartilage most frequently arising in the bones of the hand and the optimum surgical management strategy for these is debated. We present an audit of the surgical management of 57 enchondromas referred to our tertiary hand surgery department over a period of 12 years (2008–2020) and describe our surgical technique for this procedure as well as a comparison with other studies in the literature. Materials and Methods Retrospective audit of our practice. Data were extracted from our institutional operative database to identify all patients undergoing surgical management of enchondromas during the time period. The individual electronic patient records were then evaluated to extract demographics and outcome data. Results Our results demonstrate excellent clearance of enchondroma (74% Tordai group 1 radiological resolution) with very low complication rates and no recurrence. Our results also emphasize the importance of surgical management of enchondromas to allow diagnosis of rare chondrosarcoma (3.5% in this study). Conclusion A larger randomized controlled trial is still required to adequately determine the differences between the surgical options available and determine the best possible surgical approach to these cases. Level of evidence is III.

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Is the Treatment of Enchondroma in the Hand by Simple Curettage a Rewarding Method?

Abstract: 46 enchondromata of the hand have been treated by simple curettage without bone grafting. 82% healed and 16% were left with only small bone defects. Only one patient had a clear-cut recurrence requiring re-operation. This simple method, performed on out-patient basis, is recommended.

Cited by 29 publications

References 11 publications

Simple curettage and allogeneic cancellous bone chip impaction grafting in solitary enchondroma of the short tubular bones of the hand

Simple curettage and allogeneic cancellous bone chip impaction grafting in solitary enchondroma of the short tubular bones of the hand

Evaluation of risk factors for recurrence in hand enchondromas, the effect of pathological fracture and graft selection on clinical results

Surgical Management of Enchondromas of the Hand: A 12-Year Experience

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