title: Enchondromas of the hand: treatment with curettage and cemented internal fixation.
abstract: Removal by means of curettage is the mainstay of surgical treatment of enchondromas of the hand. Reconstruction traditionally entails filling the tumor cavity with a bone graft, or it may be decided not to perform a reconstruction. In either case a period of protected activity is needed until the tumor cavity has healed. The current study describes the use of cemented internal fixation for the purpose of reconstruction of these cavities. This technique provides immediate mechanical stability and allows early mobilization. Between 1986 and 1999, we treated 13 patients who were diagnosed as having enchondroma of the hand. Surgery included tumor removal with hand curettes and high-speed burr drilling. The remaining tumor cavity was reconstructed by using bone cement and intramedullary hardware. All patients were followed-up for more than 2 years. There were no postoperative infections or fractures, and all patients returned to their presurgical functional capability within 4 weeks. At the most recent follow-up evaluation, none of the patients had local tumor recurrence. Although 7 patients had a decrease in flexion of the metacarpophalangeal or interphalangeal joints, none reported a functional limitation. Reconstruction of the tumor cavity with cemented hardware provides immediate mechanical stability, allows early mobilization, and is associated with good functional outcome.
authors.affiliation: Department of Orthopedic Oncology, Washington Cancer Institute, Washington Hospital Center, George Washington University, Washington DC 20010, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bickels
authors.forename: James C
authors.initials: JC
authors.lastname: Wittig
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Kollender
authors.forename: Kristen
authors.initials: K
authors.lastname: Kellar-Graney
authors.forename: Kari L
authors.initials: KL
authors.lastname: Mansour
authors.forename: Isaac
authors.initials: I
authors.lastname: Meller
authors.forename: Martin M
authors.initials: MM
authors.lastname: Malawer
mesh_terms: D000328:Adult; D001843:Bone Cements; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D001864:Bone Wires; D002812:Chondroma / Q000601:surgery*; D003475:Curettage; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate