Simple Curettage without Bone Grafting for Enchondromata of the Hand: With Special Reference to Replacement of the Cortical Window

Goto, Takahiro; Yokokura, Satoshi; Kawano, Hirotaka; Yamamoto, Aiichiro; Matsuda, Koichi; Nakamura, Kozo

doi:10.1054/jhsb.2002.0843

Cited by 39 publications

(42 citation statements)

References 20 publications

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“…However, the technique of bone grafting involves operative harvest from a donor site having several complications, including painful scar, infection, hematoma, fracture, and gait disturbances (16). Therefore, several investigators proposed treatment of benign bone tumors by simple curettage without bone grafts and reported promising results (17)(18)(19)(20). In the current study, using a minimally invasive arthroscopic excision technique without bone grafting, most patients had eventual relief of symptoms and pain with four excellent, two good and one satisfactory wrist Mayo function result.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Curettage of Intraosseous Ganglions of the Lunate Bone

Kamrani¹,

Zanjani²,

Nabian³

2014

Shafa Ortho J

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Background: Intraosseous ganglions (IOGs) of the lunate bone are a rare cause of chronic wrist pain. Traditional treatment by open curettage and bone grafting can lead to ongoing pain and stiffness of the wrist. Objectives: In this study, an arthroscopically assisted minimally invasive technique of debridement without grafting of the lunate IOG was presented. Patients and Methods: In a prospective study, eight patients with symptomatic lunate intraosseous ganglions were treated with an arthroscopically assisted curettage technique without bone grafting in seven of them. At the preoperative examination and the last followup, wrist flexion/extension range of motion, the Mayo Wrist Performance Score, the Quick-Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score and the visual analog scale (VAS) were calculated. At final follow-up recurrence, patients' general satisfaction, return to work and complications were assessed. Results: The mean age of patients was 37 ± 8 years. The mean duration of symptoms and follow-up were 12 ± 4 and 28 ± 17 months, respectively. The mean pretreatment wrist flexion-extension arc of motion was 151 ± 46, and 174 ± 9 at the last follow-up, which was not significantly different (P = 0.23). All patients had statistically significant improvements in the Mayo functional wrist score (P < 0.01), Quick-DASH score (P < 0.01) and VAS score (P < 0.01). Conclusions: Arthroscopic debridement of intraosseous ganglions of the Lunate bone without bone grafting could improve wrist functional outcomes with fewer complications.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Curettage of Intraosseous Ganglions of the Lunate Bone

Kamrani¹,

Zanjani²,

Nabian³

2014

Shafa Ortho J

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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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“…The most common site for this lesion is the proximal phalanx, [2] followed by the metacarpals [5]. A thorough review of the literature suggests that the fifth finger is the most commonly involved in the hand with an incidence of 30-34.2% [6,7]. There has been no sex predilection for these tumors.…”

Section: Introductionmentioning

confidence: 99%

“…The exact rate of recurrence of these tumors is difficult to gauge due to the recurrent lesions being asymptomatic [9]. Sassoon et al and Gaulke et al reported a recurrence rate of 7 and 14.3% respectively [7,9]. Tao et al in his study of 20 cases reported a recurrence rate of 5% [9].…”

Section: Introductionmentioning

confidence: 99%

A rare case of recurrent enchondroma of the thumb involving the first metacarpophalangeal joint- an unusual disease pattern

Mysore¹,

Murthy²,

Nekkanti³

et al. 2018

Hand Microsurg

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Enchondromas are common benign lesions of the hand. Recurrent lesions, however, may behave notoriously. A potential malignant transformation should be kept in mind while treating such tumors. We report a case of recurrent enchondroma of the first metacarpal of the right hand in a 37-year-old lady. A 37-year-old female patient who presented to us with a recurrent swelling of the thumb. She was surgically treated for the swelling five years back. The swelling recurred four months after surgery and had grown to the current size. We successfully managed the recurrent enchondroma by en bloc excision, bone grafting, and Kirschner wires to stabilize it. Recurrent enchondromas are to be approached cautiously. They may pose a malignant threat. The reasons for recurrence are to be investigated thoroughly to avoid a re-recurrence. Successful treatment of these lesions is dependent on the complete removal of the tumor bed followed by stabilization.

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Simple Curettage without Bone Grafting for Enchondromata of the Hand: With Special Reference to Replacement of the Cortical Window

Cited by 39 publications

References 20 publications

Arthroscopic Curettage of Intraosseous Ganglions of the Lunate Bone

Arthroscopic Curettage of Intraosseous Ganglions of the Lunate Bone

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

A rare case of recurrent enchondroma of the thumb involving the first metacarpophalangeal joint- an unusual disease pattern

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