Enchondroma of the hand - treatment and long-term outcome /Enchondrome des Handskeletts - Therapeutisches Vorgehen und funktionelle Langzeitergebnisse

Löhrer L, Vordemvenne T, Neuber M, Krueger KU, Schult M, Ochman S

Abstract

An enchondroma is with up to 90% the most common benign tumour of the hand. Functional long-term outcome studies of the several treatments do not exist. The aim of this study is thus to evaluate the information from our 147 patients about diagnostics, operative treatment and follow-up treatment.147 patients with 183 histologically secured enchondromas of the hand, who had been treated between 1973 and 2004, were analysed by follow-up examination and radiological findings retrospectively.We found 136 mono- and 11 polyostotic lesions. The proximal phalanx was afflicted most commonly (44.8%). There was no preference for one special finger, only the thumb was afflicted below average (9.8%). The most common symptoms were pain and swelling (51.7%) or pathological fracture (25%). We found 11 relapses (7.5%) after an average of 4.4 years. In two cases we found a grade 1 chondrosarcoma. 84.2% of the patients achieved a "very good" or a "good" functional long-term outcome, 11.7% a "fair" and 4.2% a "poor" outcome.Standard treatment should be the accurate extirpation of the tumour and subsequent filling of the defect with cancellous bone. Only very small, asymptomatic lesions can be treated conservatively with six-month check-up examinations.