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.
Keywords
enchondroma - hand - benign neoplasms - bone transplantation
