Çapkin Sercan, Cavit Ali, Yilmaz Kutay, Kaleli Tufan
Orthopaedics and Traumatology, Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, TUR.
Orthopaedics, Uludag University School of Medicine, Bursa, TUR.
Cureus. 2020 Apr 1;12(4):e7497. doi: 10.7759/cureus.7497.
The present retrospective study evaluated the clinical and radiologic results of patients who underwent complete curettage and autologous bone grafting for hand-located isolated enchondromas with a minimum follow-up period of one year.
Thirty-two patients with a follow-up period of at least 12 months who underwent operation between August 2010 and October 2018 due to the presence of solitary enchondroma of the hand were included in the study. All patients underwent complete curettage and filling of the defect via autologous bone grafting. Autologous bone graft was harvested from the iliac crest and distal radius in 24 and eight patients, respectively. The patients underwent radiography on the first postoperative visit and at six weeks, 12 weeks, and annually. The range of movement of the finger joint was evaluated by comparing it with the healthy contralateral side. Functional outcomes and radiologic outcomes were evaluated. The frequency of complications and recurrences were established.
Twelve patients were male and 20 were female. The average age was 34 (range: 16-56) years. The most common digit involved was the little finger (nine cases, 28.125%); the proximal phalanx was the most common location (17 cases, 53.125%). Control radiography in the sixth week revealed graft consolidation in all patients. No case of nonunion or recurrence was detected clinically or radiologically, with a mean follow-up period of 54 (range: 12-96) months. Functional outcomes were classified as excellent in 28 patients and as good in four patients. The final radiographic appearances included Tordai's group 1 in 28 bones and group 2 in four bones. Conclusion: Curettage and autologous bone grafting are safe, costless, and effective treatment options for hand enchondroma, with satisfactory functional and radiographic outcomes. Harvesting bone graft from the distal radius provides a shorter length of hospital stay and lower complication rates compared to obtaining the graft from the iliac crest.
本回顾性研究评估了接受彻底刮除术及自体骨移植治疗手部孤立性内生软骨瘤且随访期至少为一年的患者的临床和放射学结果。
本研究纳入了32例随访期至少12个月的患者，这些患者在2010年8月至2018年10月期间因手部单发内生软骨瘤而接受手术。所有患者均接受了彻底刮除术，并通过自体骨移植填充缺损。分别有24例和8例患者的自体骨移植取自髂嵴和桡骨远端。患者在术后首次就诊时以及术后6周、12周和每年进行放射检查。通过与对侧健康手指关节比较来评估手指关节的活动范围。评估功能结局和放射学结局。确定并发症和复发的频率。
12例为男性，20例为女性。平均年龄为34岁（范围：16 - 56岁）。最常累及的手指是小指（9例，28.125%）；最常见的部位是近节指骨（17例，53.125%）。术后第6周的对照放射检查显示所有患者移植骨均已愈合。在平均54个月（范围：12 - 96个月）的随访期内，临床和放射学检查均未发现骨不连或复发病例。28例患者的功能结局评定为优秀，4例为良好。最终放射学表现包括28块骨为托尔代1组，4块骨为2组。结论：刮除术和自体骨移植是治疗手部内生软骨瘤安全、经济且有效的方法，功能和放射学结局均令人满意。与从髂嵴获取移植骨相比，从桡骨远端获取移植骨可缩短住院时间并降低并发症发生率。
