J Hand Microsurg 2023; 15(03): 188-195
DOI: 10.1055/s-0041-1736004
Original Article

Surgical Management of Enchondromas of the Hand: A 12-Year Experience

Natalie Redgrave
1   Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, United Kingdom
,
Dariush Nikkhah
1   Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, United Kingdom
,
Norbert Kang
1   Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, United Kingdom
,
Neil Toft
1   Department of Plastic Surgery, Royal Free Hospital, Hampstead, London, United Kingdom
› Author Affiliations

Abstract

Objective Enchondromas are benign tumours of hyaline cartilage most frequently arising in the bones of the hand and the optimum surgical management strategy for these is debated. We present an audit of the surgical management of 57 enchondromas referred to our tertiary hand surgery department over a period of 12 years (2008–2020) and describe our surgical technique for this procedure as well as a comparison with other studies in the literature.

Materials and Methods Retrospective audit of our practice. Data were extracted from our institutional operative database to identify all patients undergoing surgical management of enchondromas during the time period. The individual electronic patient records were then evaluated to extract demographics and outcome data.

Results Our results demonstrate excellent clearance of enchondroma (74% Tordai group 1 radiological resolution) with very low complication rates and no recurrence. Our results also emphasize the importance of surgical management of enchondromas to allow diagnosis of rare chondrosarcoma (3.5% in this study).

Conclusion A larger randomized controlled trial is still required to adequately determine the differences between the surgical options available and determine the best possible surgical approach to these cases. Level of evidence is III.

Note

This work has not been presented or published elsewhere.


Study Registration

The study was registered with our local trust audit department and was approved.


Authors' Contribution

All authors were involved in drafting the manuscript. All authors have reviewed and edited the manuscript and approved the final version for submission.




Publication History

Article published online:
29 September 2021

© 2021. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 O'Connor MI, Bancroft LW. Benign and malignant cartilage tumors of the hand. Hand Clin 2004; 20 (03) 317-323, vi
  • 2 Mavrogenis AF, Panagopoulos GN, Angelini A. et al. Tumors of the hand. Eur J Orthop Surg Traumatol 2017; 27 (06) 747-762
  • 3 Lubahn JD, Bachoura A. Enchondroma of the hand: evaluation and management. J Am Acad Orthop Surg 2016; 24 (09) 625-633
  • 4 Unni KK. Dahlin's Bone Tumors: General Aspects and Data on 11,087 Cases. ed. 5. Philadelphia: Lippincott-Raven; 1996: 463
  • 5 Plate AM, Steiner G, Posner MA. Malignant tumors of the hand and wrist. J Am Acad Orthop Surg 2006; 14 (12) 680-692
  • 6 Culver Jr JE, Sweet DE, McCue FC. Chondrosarcoma of the hand arising from a pre-existent benign solitary enchondroma. Clin Orthop Relat Res 1975; (113) 128-131
  • 7 Wu KK, Frost HM, Guise EE. A chondrosarcoma of the hand arising from an asymptomatic benign solitary enchondroma of 40 years' duration. J Hand Surg Am 1983; 8 (03) 317-319
  • 8 Schauer H, Fiedler B, Walker B, Müller C. [Secondary malignant transformation of an enchondroma of the hand]. Handchir Mikrochir Plast Chir 2006; 38 (03) 188-193
  • 9 Ogose A, Unni KK, Swee RG, May GK, Rowland CM, Sim FH. Chondrosarcoma of small bones of the hands and feet. Cancer 1997; 80 (01) 50-59
  • 10 Kuur E, Hansen SL, Lindequist S. Treatment of solitary enchondromas in fingers. J Hand Surg [Br] 1989; 14 (01) 109-112
  • 11 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; 15 (03) 331-334
  • 12 Goto T, Yokokura S, Kawano H, Yamamoto A, Matsuda K, Nakamura K. Simple curettage without bone grafting for enchondromata of the hand: with special reference to replacement of the cortical window. J Hand Surg [Br] 2002; 27 (05) 446-451
  • 13 Schaller P, Baer W. Operative treatment of enchondromas of the hand: is cancellous bone grafting necessary?. Scand J Plast Reconstr Surg Hand Surg 2009; 43 (05) 279-285
  • 14 Sun TT, Keung IF, Wong TC, Leung POY, Chan JSY. Enchondroma of the hand: result of surgery curettage and grafting and possible factors affecting the outcome. J OrthopTrauma Rehabil 2017; 22: 13-17
  • 15 Morii T, Mochizuki K, Tajima T, Satomi K. Treatment outcome of enchondroma by simple curettage without augmentation. J Orthop Sci 2010; 15 (01) 112-117
  • 16 Bachoura A, Rice IS, Lubahn AR, Lubahn JD. The surgical management of hand enchondroma without postcurettage void augmentation: authors' experience and a systematic review. Hand (N Y 2015; 10 (03) 461-471
  • 17 Çapkin S, Cavit A, Yilmaz K, Kaleli T. Surgical treatment of solitary enchondromas of the hand. Cureus 2020; 12 (04) e7497
  • 18 Sollaci C, de Araújo GCS. Enchondromas of the hand: a 20-year experience. Rev Bras Ortop (Sao Paulo 2019; 54 (06) 714-720
  • 19 Zhou X, Zhao B, Keshav P, Chen X, Gao W, Yan H. The management and surgical intervention timing of enchondromas: a 10-year experience. Medicine (Baltimore 2017; 96 (16) e6678
  • 20 Lu H, Chen Q, Yang H, Shen H. Enchondroma in the distal phalanx of the finger: an observational study of 34 cases in a single institution. Medicine (Baltimore 2016; 95 (38) e4966
  • 21 Hung YW, Ko WS, Liu WH. et al. Local review of treatment of hand enchondroma (artificial bone substitute versus autologous bone graft) in a tertiary referral centre: 13 years' experience. Hong Kong Med J 2015; 21 (03) 217-223
  • 22 Georgiannos D, Lampridis V, Bisbinas I. Phenolization and coralline hydroxyapatite grafting following meticulous curettage for the treatment of enchondroma of the hand. A case series of 82 patients with 5-year follow-up. Hand (N Y 2015; 10 (01) 111-115
  • 23 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; 37 (06) 1229-1234
  • 24 Figl M, Leixnering M. Retrospective review of outcome after surgical treatment of enchondromas in the hand. Arch Orthop Trauma Surg 2009; 129 (06) 729-734
  • 25 Gaulke R, Suppelna G. Solitary enchondroma at the hand. Long-term follow-up study after operative treatment. J Hand Surg [Br] 2004; 29 (01) 64-66
  • 26 Bauer RD, Lewis MM, Posner MA. Treatment of enchondromas of the hand with allograft bone. J Hand Surg Am 1988; 13 (06) 908-916
  • 27 Gaulke R. The distribution of solitary enchondromata at the hand. J Hand Surg [Br] 2002; 27 (05) 444-445
  • 28 Dimitriou R, Mataliotakis GI, Angoules AG, Kanakaris NK, Giannoudis PV. Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review. Injury 2011; 42 (Suppl. 02) S3-S15
  • 29 Myeroff C, Archdeacon M. Autogenous bone graft: donor sites and techniques. J Bone Joint Surg Am 2011; 93 (23) 2227-2236
  • 30 Bhatt RA, Rozental TD. Bone graft substitutes. Hand Clin 2012; 28 (04) 457-468
  • 31 Liodaki E, Kraemer R, Mailaender P, Stang F. The use of bone graft substitute in hand surgery: a prospective observational study. Medicine (Baltimore 2016; 95 (24) e3631