Hand Enchondromas Treated with Curettage: a Single Institution Experience and Literature Review.

IF 0.4 4区 医学 Q4 ORTHOPEDICS Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca Pub Date : 2024-01-01 DOI:10.55095/ACHOT2024/067
E Ipponi, M Cordoni, S DE Franco, F R Campo, A D'Arienzo, L Andreani
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Abstract

Purpose of the study: Hand enchondromas are benign cartilage bone tumors. Curettage represents the actual gold standard for hand enchondromas. Little has been written about the effectiveness of curettage on hand functionality.

Material and methods: In this retrospective study, we evaluated the effectiveness of curettage and bone grafting on the hand. For each case, we compared the pre-operative and post-operative QuickDASH of the treated limb. The final functional outcome was also evaluated by calculating the affected finger's Total Active Movement (TAM). Complications and local recurrences were recorded.

Results: Forty-five cases were included in our study. Fifteen of them had a pathological fracture. The mean pre-operative QuickDASH score was 48.4. No intraoperative complications occurred. After a mean follow-up of 38.1 months, the mean QuickDASH score had decreased to 4.4, and the TAM was optimal or sub-optimal. QuickDASH and TAM were significantly better for those with pathologic fractures before surgery. Only 3 cases (7%) had postoperative complications, and 1 (2%) had a local recurrence.

Discussion: Our results prove the effectiveness of curettage and early rehabilitation in increasing and restoring the performances of the treated hands. Our patients experienced a significant improvement in their functionality after surgery, generally passing from a poor to an excellent status. In our cohort, those who had a pathologic fracture before surgery had slightly but significantly worse functional outcomes compared to those who did not suffer pre-operative lesions.

Conclusions: Curettage and early postoperative rehabilitation can lead to good clinical and functional outcomes for hand enchondromas. Patients with pathologic fractures, although slightly exposed to a higher risk of sub-optimal outcomes, can also aim for good post-operative functionality.

Key words: hand, chondroma, QuickDASH, fracture, rehabilitation.

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刮痧治疗手部内生纤维瘤:单一机构经验及文献回顾。
研究目的:手部内生纤维瘤是一种良性软骨骨肿瘤。刮痧是治疗手部内生纤维瘤的黄金标准。很少有人写刮痧对手部功能的有效性。材料和方法:在本回顾性研究中,我们评估了手部刮除和植骨的有效性。对于每个病例,我们比较了术前和术后治疗肢体的QuickDASH。最后的功能结果也通过计算受影响手指的总活跃运动(TAM)来评估。记录并发症及局部复发情况。结果:本组共纳入45例病例。其中15人有病理性骨折。术前QuickDASH平均评分为48.4分。无术中并发症发生。平均随访38.1个月后,QuickDASH平均评分降至4.4分,TAM为最佳或次优。术前病理性骨折患者采用QuickDASH和TAM治疗效果明显较好。术后并发症3例(7%),局部复发1例(2%)。讨论:我们的结果证明刮痧和早期康复在提高和恢复治疗手的性能方面是有效的。我们的病人在手术后的功能有了显著的改善,通常从差到好。在我们的队列中,术前发生病理性骨折的患者与术前未发生病变的患者相比,其功能预后轻微但明显更差。结论:刮除术和术后早期康复治疗手内生纤维瘤可获得良好的临床和功能预后。病理性骨折患者,虽然稍微暴露于风险较高的次优结果,也可以以良好的术后功能为目标。关键词:手部,软骨瘤,QuickDASH,骨折,康复。
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来源期刊
CiteScore
0.70
自引率
25.00%
发文量
53
期刊介绍: Editorial Board accepts for publication articles, reports from congresses, fellowships, book reviews, reports concerning activities of orthopaedic and other relating specialised societies, reports on anniversaries of outstanding personalities in orthopaedics and announcements of congresses and symposia being prepared. Articles include original papers, case reports and current concepts reviews and recently also instructional lectures.
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