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 70 publications

(51 citation statements)

References 12 publications

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“…It is well-known that a fresh fracture is surrounded by hematoma, and this hematoma will be invaded by multipotent mesenchymal cells which diVerentiate into osteoblasts, a pre-requisite for bone healing [7]. Therfeore, curettage has recently become the mainstay of surgical treatment for enchondroma.…”

Section: Discussionmentioning

confidence: 99%

Fracture of the calcium phosphate bone cement which used to enchondroma of the hand: a case report

Naïto

Obayashi

Mogami

et al. 2008

Eur J Orthop Surg Traumatol

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Section: Discussionmentioning

confidence: 99%

Fracture of the calcium phosphate bone cement which used to enchondroma of the hand: a case report

Naïto

Obayashi

Mogami

et al. 2008

Eur J Orthop Surg Traumatol

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“…In cases of solitary enchondroma, some authors have recommended simple curettage without bone grafting and have reported good clinical results, especially in younger patients. However, such patients must undergo casting and wait for 4 to 6 weeks before they can resume unrestricted daily activity, and some patients experience joint contracture of the affected limb [7,16,17]. Autologous bone grafting is performed conventionally, but the contribution of cancellous bone to the structural strength in the short term is considered to be very low [9].…”

Section: Discussionmentioning

confidence: 99%

Ollier's Disease Treated with Grafting Using Alpha-tricalcium Phosphate Cement. ACase Report

Sasaki

Hatori

Abe

et al. 2006

Upsala Journal of Medical Sciences

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Ollier's disease is a rare disorder characterized by multiple enchondromas with a unilateral predominance, especially in fingers in early childhood. We experienced a case of Ollier's disease treated four times with simple curettage from the age of 2 years and alpha-tricalcium phosphate cement grafting at the age of 21 years. The forth curettage was performed when the patient was 15 years old and preoperative X-rays had shown remarkable finger deformities. Postoperative casting of the involved joints was necessary to prevent fractures but led to some finger contractures. Following X-rays demonstrated incredible improvement of the appearance. This suggests that simple curettage alone at an early stage of Ollier's disease provide cosmetic improvement.At the age of 21 years our patient showed enlargement of the intramedullary finger lesions again. Some lesions seemed to be impending pathological fractures. This time we chose alpha-tricalcium phosphate cement to fill the cavities after curettage had been carried out. Harvesting a large amount of autologous bone was not required. All activities of daily life could be resumed immediately after surgery and none of the finger joints showed further restriction of motion. X-rays taken three years after the operation showed new bone ingrowth surrounding the material with little evidence of absorption. To our knowledge, this may be the first case of Ollier's disease treated with artificial bone grafting reported in the English literature. 249

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“…This is a well accepted method of repair because patients treated with curettage alone will form new bone to fill in the surgical cavity (7,8). It has been hypothesized that the hematoma at the fracture site becomes invaded by mesenchymal multipotent cells which can differentiate into osteoblasts providing the cellular network for bone growth (8).…”

Section: Discussionmentioning

confidence: 99%

Avulsion of the flexor digitorum tendon secondary to enchondroma of the distal phalanx

Wong¹

2004

J Plast Surg

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. Avulsion of the flexor digitorum tendon secondary to enchondroma of the distal phalanx. Can J Plast Surg 2004;12(2):67-68.Flexor digitorum profundus (FDP) tendon avulsion is a common injury in sports. This is secondary to forced extension against flexor digitorum profundus contraction. However, avulsion injury of the FDP tendon secondary to an enchondroma of the distal phalanx is extremely rare. There have only been three previous reports of such an occurrence. This report describes a fourth case of an avulsion injury of the FDP tendon secondary to enchondroma of the distal phalanx of the fourth digit.Key Words: Distal phalanx; Enchondroma; FDP avulsion fracture L'avulsion du tendon fléchisseur des doigts secondaire à un chondrome de la phalange distale L'avulsion du tendon fléchisseur profond (TFP) est une blessure sportive courante, secondaire à une extension forcée à la contraction du TFP. Cependant, une lésion d'avulsion du TFP secondaire à un chondrome de la phalange distale est d'une extrême rareté. Seulement trois cas de ce genre ont été déclarés. Le présent compte rendu décrit un quatrième cas de lésion d'avulsion du TFP secondaire à un chondrome de la phalange distale de l'annulaire.A 38-year-old right-hand-dominant man, otherwise healthy, experienced severe pain in his left fourth digit after he accidentally tapped his hand on a cleat while sailing. On clinical examination, the left fourth distal interphalangeal (DIP) joint was tender and swollen with loss of active flexion. A review of the x-rays showed an avulsion fracture and a welldefined geographic lytic lesion, consistent with an enchondroma, at the base of the distal phalanx (Figure 1).One week after the initial injury, surgical exploration was initiated with an incision over the palmar aspect of the DIP joint. The fracture site was identified at the distal phalanx. The profundus tendon was attached to the avulsed fragment, which had retracted to the A4 pulley. The enchondroma was exposed and removed by curettage creating a corticocancellous bone defect. A bolster suture was used to fix the avulsed fragment to the distal phalanx (1). Pathology was sent and confirmed the diagnosis. Postoperatively, the fourth and fifth digits were kept in flexion with a dorsal splint. Physiotherapy and active exercises began at three weeks. After a four-month course of physiotherapy the patient was pain free, with 52°a ctive flexion and -10° active extension of his left fourth DIP. A review of x-rays taken five months postoperatively shows the previously avulsed articular fragment to be reduced and healed in place (Figure 2).The patient remained pain free seven months postoperatively.

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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 70 publications

References 12 publications

Fracture of the calcium phosphate bone cement which used to enchondroma of the hand: a case report

Fracture of the calcium phosphate bone cement which used to enchondroma of the hand: a case report

Ollier's Disease Treated with Grafting Using Alpha-tricalcium Phosphate Cement. ACase Report

Avulsion of the flexor digitorum tendon secondary to enchondroma of the distal phalanx

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