PURPOSE: To report the results of treatment of enchondroma of the hand managed by curettage and calcium phosphate bone cement (CPC) grafting. METHODS: Ten patients with digital enchondroma were reviewed. There were 6 proximal phalanges, 2 middle phalanges, and 2 metacarpal bones. The average patient age at surgery was 31 years. The average follow-up period was 41 months. We reviewed the final function and radiographic appearance of the surgically treated digits. We defined the term bony incorporation of CPC as a seamless change of radiographic appearance and no gap between cancellous bone and CPC. RESULTS: At final evaluation the bony incorporation was uneventful in all patients. Radiographs showed apparent partial absorption of CPC in only 2 patients. All digits had full range of motion after surgery. One digit fixed with multiple pins to treat a pathologic fracture simultaneously resulted in malunion and needed additional surgeries to correct digital overlap. No other complications were encountered. CONCLUSIONS: Patients with enchondroma of the hand are good candidates for treatment with CPC. In the case of pathologic fracture before surgery, however, surgery may be delayed until fracture healing because early corrective osteotomy with CPC might be difficult in a patient with malunion TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.
PURPOSE: To report the results of treatment of enchondroma of the hand managed by curettage and calcium phosphate bone cement (CPC) grafting. METHODS: Ten patients with digital enchondroma were reviewed. There were 6 proximal phalanges, 2 middle phalanges, and 2 metacarpal bones. The average patient age at surgery was 31 years. The average follow-up period was 41 months. We reviewed the final function and radiographic appearance of the surgically treated digits. We defined the term bony incorporation of CPC as a seamless change of radiographic appearance and no gap between cancellous bone and CPC. RESULTS: At final evaluation the bony incorporation was uneventful in all patients. Radiographs showed apparent partial absorption of CPC in only 2 patients. All digits had full range of motion after surgery. One digit fixed with multiple pins to treat a pathologic fracture simultaneously resulted in malunion and needed additional surgeries to correct digital overlap. No other complications were encountered. CONCLUSIONS:Patients with enchondroma of the hand are good candidates for treatment with CPC. In the case of pathologic fracture before surgery, however, surgery may be delayed until fracture healing because early corrective osteotomy with CPC might be difficult in a patient with malunion TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.
Authors: Mohammad Al Rajeh; Juan José Hidalgo Diaz; Sybille Facca; Anne Sophie Matheron; Stéphanie Gouzou; Philippe Liverneaux Journal: Eur J Orthop Surg Traumatol Date: 2016-12-09