INFLUENCE FACTORS ANALYSIS OF SURGICAL EFFECTIVENESS FOR SOLITARY ENCHONDROMA OF HAND WITH PATHOLOGIC FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHENGWei ,  XIONGGe , LIChun , ZHANGYoule

Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China;

Corresponding?author：

XIONGGe, Email: xiongge@sohu.com

Keywords：

Solitary enchondroma; Pathologic fracture; Surgical effectiveness; Influence factor

DOI：

10.7507/1002-1892.20140185

Video：

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Objective To explore the influence factors of the surgical effectiveness for solitary enchondroma of the hand with pathologic fracture. Methods A retrospective analysis was made on the clinical data of 65 patients with solitary enchondroma of the hand with pathologic fracture who were treated with operation and were accorded with selective standard between March 2010 and June 2013.There were 26 males and 39 females,aged 17 to 63 years (mean,36 years).The left hands were involved in 32 cases and the right hands in 33 cases.The tumor located at the metacarpus in 18 cases,and at the phalanx in 47 cases (at the proximal phalanx in 30 cases,at the middle phalanx in 9 cases,and at the distal phalanx in 8 cases).The duration from fracture to operation was 2 days to 2 years (mean,56 days).The operative methods were curettage and bone grafting.The ratios of the total active range of motion (ROM) of the metacarpophalangeal joint and interphalangeal joint between ipsilateral and contralateral fingers were used to evaluate the ipsilateral fingers'function.The time of returning to work was recorded.The multiple linear regressions were performed to analyze the risk factors of the effectiveness. Results A total of 65 cases were followed up 5-44 months (mean,24 months).All incisions achieved primary healing.No infection,re-fracture,or recurrence occurred.The X-ray films showed fracture healing,the healing time was 5-10 weeks (mean,6.5 weeks).All the bone grafts healed well.At last follow-up,the ROM ratio of the fingers was 0.46-1.00(mean,0.90).The time of returning to work was 92-180 days (mean,130 days).Multiple linear regressions showed that internal fixation was risk factor for the ROM ratio of the fingers (P=0.013).The duration from fracture to operation,internal fixation,and the tumor site were risk factors for the time of returning to work (P<0.05). Conclusion To obtain good effectiveness for patients with solitary enchondroma of the hand with pathologic fracture,it is suggested that immediate operative treatment including tumor curettage,open reduction,and internal fixation with plate and screws of the fracture.

Citation： ZHENGWei, XIONGGe, LIChun, ZHANGYoule. INFLUENCE FACTORS ANALYSIS OF SURGICAL EFFECTIVENESS FOR SOLITARY ENCHONDROMA OF HAND WITH PATHOLOGIC FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(7): 840-843. doi: 10.7507/1002-1892.20140185 Copy

1.	Morii T,Mochizuki K,Tajima T,et al.Treatment outcome of enchondroma by simple curettage without augmentation.J Orthop Sci,2010,15(1):112-117.
2.	Gaasbeek R,Rijnberg W,van Loon C,et al.No local recurrence of enchondroma after curettage and plaster filling.Arch Orthop Trauma Surg,2005,125(1):42-45.
3.	Gaulke R,Suppelna G.Solitary enchondroma at the hand.Long-term follow-up study after operative treatment.J Hand Surg (Br),2004,29(1):64-66.
4.	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(5):279-285.
5.	Bird JE,Wang WL,Deavers MT,et al.Enchondroma with secondary aneurismal bone cyst.Skeletal Radiol,2012,41(11):1475-1478.
6.	Jacobson ME,Ruff ME.Solitary enchondroma of the phalanx.J Hand Surg (Am),2011,36(11):1845-1847.
7.	Douis H,Saifuddin A.The imaging of cartilaginous bone tumours.I.Benign lesions.Skeletal Radiol,2012,41(10):1195-1212.
8.	Figl M,Leixnering M.Retrospective review of outcome after surgical treatment of enchondromas in the hand.Arch Orthop Trauma Surg,2009,129(6):729-734.
9.	Bickels J,Wittig JC,Kollender Y,et al.Enchondromas of the hand:treatment with curettageand cemented internal fixation.J Hand Surg (Am),2002,27(5):870-875.
10.	Sassoon AA,Fitz-Gibbon PD,Harmsen WS,et al.Enchondromas of the hand:factors affecting recurrence,healing,motion,and malignant transformation.J Hand Surg (Am),2012,37(6):1229-1234.
11.	楊勇,田文,李淳,等.單純病灶刮除治療手部內生軟骨瘤的療效分析.中華手外科雜志,2011,27(4):202-204.
12.	趙勇,竺湘江,潘科良,等.病灶刮除加自體髂骨植入治療手部內生軟骨瘤21例.臨床骨科雜志,2011,14(2):236-237.
13.	戴魯飛,田光磊,熊革,等.可注射型人工骨治療手部內生軟骨瘤.中華手外科雜志,2013,29(2):76-77.
14.	趙睿,叢銳,李靖,等.磷酸鈣生物陶瓷在治療手部內生軟骨瘤中的臨床應用.中華手外科雜志,2009,25(5):273-274.
15.	Yasuda M,Masada K,Takeuchi E.Treatment of enchondroma of the hand with injectable calcium phosphate bone cement.J Hand Surg (Am),2006,31(1):98-102.
16.	Ablove RH,Moy OJ,Peimer CA,et al.Early versus delayed treatment of enchondroma.Am J Orthop (Belle Mead NJ),2000,29(10):771-772.
17.	Lin SY,Huang PJ,Huang HT,et al.An alternative technique for the management of phalangeal enchondromas with pathologic fractures.J Hand Surg (Am),2013,38(1):104-109.

1. Morii T,Mochizuki K,Tajima T,et al.Treatment outcome of enchondroma by simple curettage without augmentation.J Orthop Sci,2010,15(1):112-117.
2. Gaasbeek R,Rijnberg W,van Loon C,et al.No local recurrence of enchondroma after curettage and plaster filling.Arch Orthop Trauma Surg,2005,125(1):42-45.
3. Gaulke R,Suppelna G.Solitary enchondroma at the hand.Long-term follow-up study after operative treatment.J Hand Surg (Br),2004,29(1):64-66.
4. 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(5):279-285.
5. Bird JE,Wang WL,Deavers MT,et al.Enchondroma with secondary aneurismal bone cyst.Skeletal Radiol,2012,41(11):1475-1478.
6. Jacobson ME,Ruff ME.Solitary enchondroma of the phalanx.J Hand Surg (Am),2011,36(11):1845-1847.
7. Douis H,Saifuddin A.The imaging of cartilaginous bone tumours.I.Benign lesions.Skeletal Radiol,2012,41(10):1195-1212.
8. Figl M,Leixnering M.Retrospective review of outcome after surgical treatment of enchondromas in the hand.Arch Orthop Trauma Surg,2009,129(6):729-734.
9. Bickels J,Wittig JC,Kollender Y,et al.Enchondromas of the hand:treatment with curettageand cemented internal fixation.J Hand Surg (Am),2002,27(5):870-875.
10. Sassoon AA,Fitz-Gibbon PD,Harmsen WS,et al.Enchondromas of the hand:factors affecting recurrence,healing,motion,and malignant transformation.J Hand Surg (Am),2012,37(6):1229-1234.
11. 楊勇,田文,李淳,等.單純病灶刮除治療手部內生軟骨瘤的療效分析.中華手外科雜志,2011,27(4):202-204.
12. 趙勇,竺湘江,潘科良,等.病灶刮除加自體髂骨植入治療手部內生軟骨瘤21例.臨床骨科雜志,2011,14(2):236-237.
13. 戴魯飛,田光磊,熊革,等.可注射型人工骨治療手部內生軟骨瘤.中華手外科雜志,2013,29(2):76-77.
14. 趙睿,叢銳,李靖,等.磷酸鈣生物陶瓷在治療手部內生軟骨瘤中的臨床應用.中華手外科雜志,2009,25(5):273-274.
15. Yasuda M,Masada K,Takeuchi E.Treatment of enchondroma of the hand with injectable calcium phosphate bone cement.J Hand Surg (Am),2006,31(1):98-102.
16. Ablove RH,Moy OJ,Peimer CA,et al.Early versus delayed treatment of enchondroma.Am J Orthop (Belle Mead NJ),2000,29(10):771-772.
17. Lin SY,Huang PJ,Huang HT,et al.An alternative technique for the management of phalangeal enchondromas with pathologic fractures.J Hand Surg (Am),2013,38(1):104-109.

Chinese Journal of Reparative and Reconstructive Surgery

INFLUENCE FACTORS ANALYSIS OF SURGICAL EFFECTIVENESS FOR SOLITARY ENCHONDROMA OF HAND WITH PATHOLOGIC FRACTURE

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