CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(06): 714-720
DOI: 10.1055/s-0039-1697970
Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Enchondromas of the Hand: A 20-year Experience[*]

Article in several languages: português | English
Claudio Sollaci
1  Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil
,
1  Rede Sarah de Hospitais de Reabilitação, Brasília, DF, Brasil
2  Universidade Federal Fluminense, Niterói, RJ, Brasil
› Author Affiliations
Further Information

Publication History

25 March 2018

02 July 2018

Publication Date:
09 October 2019 (online)

Abstract

Objective Enchondromas are the commonest tumors of the bones of the hand. Treatment approaches vary. The present article presents the characteristics of the tumors, diagnostic methods, and treatments.

Methods We discuss the approach used in our institution, where we have treated 48 patients with enchondromas of the hand between 1996 and 2016. Our technique of treatment, which has remained the same over 2 decades, comprises the use of curettage, high-speed burr, and autologous bone graft (harvested with a minimally invasive technique, using a Craig biopsy needle).

Results Pain and fractures were the most common symptoms leading the patients to consultation, at frequencies of 33.3% and 31.3%, respectively. A total of 27.1% of the cases were asymptomatic, and their lesions were discovered incidentally. The mean age was 34.4 years (SD = 12.9 years). Tumors were more frequently presented in the ulnar side of the hand, in the fifth ray (41.5%) and in the proximal bones (in the proximal phalanges [43.8%], and in the metacarpal [33.3%]). The size of the tumors ranged from 0.2 cm2 to 5.7 cm2, with a mean of 1.7 cm2 (standard deviation [SD] = 1.0 cm2) and were not associated with fracture (p = 0.291). Fracture was also not associated with any of the symptoms, neither with the age of the patients (p = 0.964). After the treatment, most patients achieved full range of motion (91.7%), with good integration of the bone graft. Three patients presented deficit in range of motion (6.3%) and the incidence of complications was also 6.3% (3 patients). At the end, after the needed surgical revisions, these three patients also recovered full function. They achieved full bone graft integration, regained full range of motion and returned to work. There was no tumor recurrence case during the follow-up period evaluated. For all cases, no donor site complications occurred.

Conclusion Our method of treatment has consistently provided good outcomes, with only a few minor complications. Therapeutic level of evidence: IV.

* Study conducted at Rede Sarah de Hospitais de Reabilitação, Brasília, Distrito Federal, Brazil.