Hung Y W, Ko W S, Liu W H, Chow C S, Kwok Y Y, Wong Clara W Y, Tse W L, Ho P C
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, Hong Kong.
Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong.
Hong Kong Med J. 2015 Jun;21(3):217-23. doi: 10.12809/hkmj144325. Epub 2015 Mar 26.
To evaluate the treatment outcomes of enchondroma of the hand with artificial bone substitute versus autologous (iliac) bone graft.
Historical cohort study.
Tertiary referral centre, Hong Kong.
A total of 24 patients with hand enchondroma from January 2001 to December 2013 who underwent operation at the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong were reviewed. Thorough curettage of the tumour was performed in all patients, followed by either autologous bone graft impaction under general anaesthesia in 13 patients, or artificial bone substitute in 11 patients (10 procedures were performed under local or regional anaesthesia and 1 was done under general anaesthesia). The functional outcomes and bone incorporation were measured by QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire) scores and radiological appearance, respectively. The mean follow-up period was 59 months.
There were eight men and 16 women, with a mean age of 40 years. Overall, 17 cases involved phalangeal bones and seven involved metacarpal bones. Among both groups of patients, most of the affected digits had good range of motion and function after surgery. One patient in each study group had complications of local soft tissue inflammation. One patient in the artificial bone substitute group was suspected to have recurrence 8 years after operation. Among the autologous bone graft group, four patients had persistent donor site morbidity at the last follow-up. In all patients, radiographs showed satisfactory bone incorporation.
Artificial bone substitute is a safe and effective treatment option for hand enchondroma, with satisfactory functional and radiographic outcomes. Artificial bone substitute offers the additional benefits of enabling the procedure to be done under local anaesthesia on a day-case basis with minimal complications.
比较人工骨替代物与自体（髂骨）骨移植治疗手部内生软骨瘤的疗效。
历史性队列研究。
香港三级转诊中心。
回顾性分析2001年1月至2013年12月在香港威尔士亲王医院和雅丽氏何妙龄那打素医院接受手术的24例手部内生软骨瘤患者。所有患者均接受了肿瘤的彻底刮除术，随后13例患者在全身麻醉下进行自体骨移植打压植骨，11例患者使用人工骨替代物（10例在局部或区域麻醉下进行，1例在全身麻醉下进行）。分别通过QuickDASH（手臂、肩部和手部功能障碍问卷简版）评分和影像学表现评估功能结局和骨融合情况。平均随访时间为59个月。
男性8例，女性16例，平均年龄40岁。总体而言，17例累及指骨，7例累及掌骨。两组患者术后大多数患指活动范围和功能良好。每个研究组各有1例患者出现局部软组织炎症并发症。人工骨替代物组1例患者术后8年疑似复发。自体骨移植组4例患者在最后一次随访时供区仍有不适。所有患者的X线片显示骨融合情况良好。
人工骨替代物是治疗手部内生软骨瘤的一种安全有效的选择，功能和影像学结局均令人满意。人工骨替代物还具有可在局部麻醉下日间手术完成、并发症少的额外优势。
