Evaluation of risk factors for recurrence in hand enchondromas, the effect of pathological fracture and graft selection on clinical results
Öz
Objective:
Enchondroma is the most common tumor of phalanx and metacarpus. Various techniques and methods have already been investigated for a long time. We aimed to examine the clinical and radiological results of curettage and bone substitute used in a broad spectrum of patients with an enchondroma.
Methods:
Forty-seven patients operated with the diagnosis of enchondroma were included in the study. Curettage and filling of the cavity with bone substitutes were performed. The mean age of the patients was 29.3215.08 years, and follow-up was 28.4725.10 months. Patients who did not comply with standard follow-up protocol were excluded. An experienced orthopedic surgeon evaluated radiological results, and MRI reports and images for patients with recurrences were extracted from the hospital database. Clinical assessment was made according to range of motion and observed deformity.
Findings:
Mean consolidation time was 3.08±2.19 months. The recurrence rate was 6.4%. There was no difference between groups admitted with fracture and w/o fracture, allograft and autograft group in terms of clinical and radiological results.
Conclusion:
Curettage and grafting was still an upcoming and safe method for enchondroma
Anahtar Kelimeler
Kaynakça
- 1. Gaulke R. The distribution of solitary enchondromata at the hand. J Hand Surg Br. 2002 Oct;27(5):444-5. doi: 10.1054/jhsb.2002.0826. PMID: 12367543.
- 2. Li, Qingyuan MD; Kim, Jihyeung MD, PhD; Kim, Sang Yoon MD; Baek, Goo Hyun MD, PhD. Early Surgical Treatment of Both Tumor and Fracture in Patients With Enchondroma of the Hand Combined With Pathologic Fracture. Annals of Plastic Surgery: September 2021 - Volume 87 - Issue 3 - p 260-264 doi: 10.1097/SAP.0000000000002776
- 3. Boriani F, Raposio E, Errani C. Imaging Features of Primary Tumors of the Hand. Curr Med Imaging. 2021;17(2):179-196. doi: 10.2174/1573405616999200817173154. PMID: 32811403.
- 4. Tordai P, Hoglund M, Lugnegård H. Is the treatment of enchondroma in the hand by simple curettage a rewarding method? J Hand Surg Br. 1990 Aug;15(3):331-4. doi: 10.1016/0266-7681(90)90013-t. PMID: 2230500.5.
- 5. Belusa M. (1981). Zur operativen Behandlung der Enchondrome der Hand. Zur Artztliche Fortbildung, 75: 111-112.
- 6. Takigawa K. (1971). Chondroma of the Bones of the Hand. A Review of 110 Cases. Joumal of Bone and Joint Surgery, 53A: 8: 1591-1600.
- 7. M.A. Rajeh, J.J. Diaz, S. Facca, A.S. Matheron, S. Gouzou, P. Liverneaux, Treatment of hand enchondroma with injectable calcium phosphate cement: a series of eight cases, Eur. J. Orthop. Surg. Traumatol. 27 (2) (2017) 251–254, https://doi.org/ 10.1007/s00590-016-1888-2.
- 8. M. Yalcinkaya, Y.E. Akman, A.E. Bagatur, Recurrent metacarpal enchondroma treated with strut allograft: 14-year follow-up, Orthopedics 38 (7) (2015) e647–650, https://doi.org/10.3928/01477447-20150701-92.
- 9. Sassoon AA, Fitz-Gibbon PD, Harmsen WS, Moran SL. Enchondromas of the hand: factors affecting recurrence, healing, motion, and malignant transformation. J Hand Surg Am. 2012 Jun;37(6):1229-34. doi: 10.1016/j.jhsa.2012.03.019. Epub 2012 Apr 27. PMID: 22542061.
- 10. Lubahn JD, Bachoura A. Enchondroma of the Hand: Evaluation and Management. J Am Acad Orthop Surg. 2016 Sep;24(9):625-33. doi: 10.5435/JAAOS-D-15-00452. PMID: 27454024.
- 11. Hasselgren G, Forssblad P, Törnvall A. Bone grafting unnecessary in the treatment of enchondromas in the hand. J Hand Surg 1991;16A: 139–142.
- 12. Lin SY, Huang PJ, Huang HT, Chen CH, Cheng YM, Fu YC: An alternative technique for the management of phalangeal enchondromas with pathologic fractures. J Hand Surg Am 2013;38(1):104-109.
- 13. Zheng H, Liu J, Dai X, Schilling AF: Modified technique for one-stage treatment of proximal phalangeal enchondromas with pathologic fractures. J Hand Surg Am 2014;39(9):1757-1760.
- 14. Ablove RH, Moy OJ, Peimer CA, Wheeler DR. Early versus delayed treatment of enchondroma. Am J Orthop (Belle Mead NJ) 2000;29: 771–772.
- 15. Yusada M, Masada K, Takeuchi E. Treatment of enchondroma of the hand with injectable calcium phosphate bone cement. J Hand Surg 2006;31A:98 –102.
- 16. Nazarova NZ, Umarova GS, Vaiman M, Asilova SU, Abba M, Foonberg M, Shterenshis M. The surgical management of the cavity and bone defects in enchondroma cases: A prospective randomized trial. Surg Oncol. 2021 Jun;37:101565. doi: 10.1016/j.suronc.2021.101565. Epub 2021 Apr 5. PMID: 33848764.
El enkondromlarında nüks risk faktörlerinin değerlendirilmesi, patolojik kırık ve greft seçiminin klinik sonuçlara etkisi
Öz
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.
Anahtar Kelimeler
Kaynakça
- 1. Gaulke R. The distribution of solitary enchondromata at the hand. J Hand Surg Br. 2002 Oct;27(5):444-5. doi: 10.1054/jhsb.2002.0826. PMID: 12367543.
- 2. Li, Qingyuan MD; Kim, Jihyeung MD, PhD; Kim, Sang Yoon MD; Baek, Goo Hyun MD, PhD. Early Surgical Treatment of Both Tumor and Fracture in Patients With Enchondroma of the Hand Combined With Pathologic Fracture. Annals of Plastic Surgery: September 2021 - Volume 87 - Issue 3 - p 260-264 doi: 10.1097/SAP.0000000000002776
- 3. Boriani F, Raposio E, Errani C. Imaging Features of Primary Tumors of the Hand. Curr Med Imaging. 2021;17(2):179-196. doi: 10.2174/1573405616999200817173154. PMID: 32811403.
- 4. Tordai P, Hoglund M, Lugnegård H. Is the treatment of enchondroma in the hand by simple curettage a rewarding method? J Hand Surg Br. 1990 Aug;15(3):331-4. doi: 10.1016/0266-7681(90)90013-t. PMID: 2230500.5.
- 5. Belusa M. (1981). Zur operativen Behandlung der Enchondrome der Hand. Zur Artztliche Fortbildung, 75: 111-112.
- 6. Takigawa K. (1971). Chondroma of the Bones of the Hand. A Review of 110 Cases. Joumal of Bone and Joint Surgery, 53A: 8: 1591-1600.
- 7. M.A. Rajeh, J.J. Diaz, S. Facca, A.S. Matheron, S. Gouzou, P. Liverneaux, Treatment of hand enchondroma with injectable calcium phosphate cement: a series of eight cases, Eur. J. Orthop. Surg. Traumatol. 27 (2) (2017) 251–254, https://doi.org/ 10.1007/s00590-016-1888-2.
- 8. M. Yalcinkaya, Y.E. Akman, A.E. Bagatur, Recurrent metacarpal enchondroma treated with strut allograft: 14-year follow-up, Orthopedics 38 (7) (2015) e647–650, https://doi.org/10.3928/01477447-20150701-92.
- 9. Sassoon AA, Fitz-Gibbon PD, Harmsen WS, Moran SL. Enchondromas of the hand: factors affecting recurrence, healing, motion, and malignant transformation. J Hand Surg Am. 2012 Jun;37(6):1229-34. doi: 10.1016/j.jhsa.2012.03.019. Epub 2012 Apr 27. PMID: 22542061.
- 10. Lubahn JD, Bachoura A. Enchondroma of the Hand: Evaluation and Management. J Am Acad Orthop Surg. 2016 Sep;24(9):625-33. doi: 10.5435/JAAOS-D-15-00452. PMID: 27454024.
- 11. Hasselgren G, Forssblad P, Törnvall A. Bone grafting unnecessary in the treatment of enchondromas in the hand. J Hand Surg 1991;16A: 139–142.
- 12. Lin SY, Huang PJ, Huang HT, Chen CH, Cheng YM, Fu YC: An alternative technique for the management of phalangeal enchondromas with pathologic fractures. J Hand Surg Am 2013;38(1):104-109.
- 13. Zheng H, Liu J, Dai X, Schilling AF: Modified technique for one-stage treatment of proximal phalangeal enchondromas with pathologic fractures. J Hand Surg Am 2014;39(9):1757-1760.
- 14. Ablove RH, Moy OJ, Peimer CA, Wheeler DR. Early versus delayed treatment of enchondroma. Am J Orthop (Belle Mead NJ) 2000;29: 771–772.
- 15. Yusada M, Masada K, Takeuchi E. Treatment of enchondroma of the hand with injectable calcium phosphate bone cement. J Hand Surg 2006;31A:98 –102.
- 16. Nazarova NZ, Umarova GS, Vaiman M, Asilova SU, Abba M, Foonberg M, Shterenshis M. The surgical management of the cavity and bone defects in enchondroma cases: A prospective randomized trial. Surg Oncol. 2021 Jun;37:101565. doi: 10.1016/j.suronc.2021.101565. Epub 2021 Apr 5. PMID: 33848764.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Ortopedi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2022 |
| Kabul Tarihi | 27 Eylül 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 5 Sayı: 3 |
