CORTICOPLASTY FOR MULTIPLE ENCHONDROMATOSIS OF HAND_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANGYong ,  TIANWen , LIChun , ZHAOJunhui , WANGHaihua , XUEYunhao , TIANGuanglei

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

Corresponding author：

TIANWen, Email: wentiansyz@hotmail.com

Keywords：

Enchondromatosis; Hand tumor; Curettage; Corticoplasty

DOI：

10.7507/1002-1892.20140008

Video：

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Objective To evaluate the results of corticoplasty for multiple enchondromatosis of the hand. Methods Between February 2003 and January 2011, 6 patients with multiple enchondromatosis were treated. Of 6 cases, 1 was boy and 5 were girls with an average age of 10.8 years (range, 9-12 years); 5 cases presented with painless mass as first symptom, and 1 case was found to have mass by X-ray film because of hand injury. Physical examination at admission showed multiple mass on the hands, fingers deformity, and limited range of motion; X-ray film results showed large lesions in the phalanges and metacarpals. Corticoplasty and simple curettage without bone grafting were performed on 24 fingers (60 bones) with multiple enchondromatosis of the hand. The fingers active range of motion was used to evaluate the finger function; the diameter of the tumors was measured on the X-ray films; and according to Tordai's classification, tumor recurrence and new bone formation were observed. Results Once, twice, or three-time operations were performed in 2 cases, respectively. All patients were followed up 17-83 months with an average of 52.2 months. At last follow-up, the active range of motion was significantly increased from (230.8±53.2)° at preoperation to (255.0±28.7)° at postoperation (t=—3.829, P=0.001); the tumor diameter was significantly decreased from (15.6±5.8) mm at preoperation to (10.7±3.7) mm at postoperation (t=8.304, P=0.000). Of 60 bones, 34 (56.7%) were rated as Tordai grade 1, and 26 (43.3%) as Tordai grade 2. During follow-up, clinical manifestation, characteristics of radiology and pathological examination showed no pathological fracture or malignant change. Conclusion Corticoplasty is a safe and effective treatment for multiple enchondromatosis of the hand in children. The procedure can improve appearance and motion function of the hand.

Citation： YANGYong, TIANWen, LIChun, ZHAOJunhui, WANGHaihua, XUEYunhao, TIANGuanglei. CORTICOPLASTY FOR MULTIPLE ENCHONDROMATOSIS OF HAND. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(1): 34-37. doi: 10.7507/1002-1892.20140008 Copy

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7.	Hasselgren G,Forssblad P,Törnvall A.Bone grafting unnecessary in the treatment of enchondromas in the hand.J Hand Surg (Am),1991,16(1):139-142.
8.	杨勇,田文,李淳,等.单纯病灶刮除治疗手部内生软骨瘤的疗效分析.中华手外科杂志,2011,27(4):202-204.
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12.	Omokawa S,Tamai S,Takakura Y,et al.A long-term study of the donor-site ankle after vascularized fibula grafts in children.Microsurgery,1996,17(3):162-166.
13.	Sekiya I,Matsui N,Otsuka T,et al.The treatment of enchondromas in the hand by endoscopic curettage without bone grafting.J Hand Surg (Br),1997,22(2):230-234.
14.	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.
15.	Schwartz HS,Zimmerman NB,Simon MA,et al.The malignant potential of enchondromatosis.J Bone Joint Surg (Am),1987,69(2):269-274.
16.	Liu J,Hudkins PG,Swee RG,et al.Bone sarcomas associated with Ollier's disease.Cancer,1987,59(7):1376-1385.

1. Silve C,Jüppner H.Ollier disease.Orphanet J Rare Dis,2006,22(1):37-43.
2. Fatti JF,Mosher JF.Treatment of multiple enchondromatosis (Ollier's disease) of the hand.Orthopedics,1986,9(4):512-518.
3. Ulutaş K,Menderes A,Yilmaz M.Enchondromatosis of the hand:severe and mild forms,and treatment modalities.Ann Plast Surg,2001,47(2):214-215.
4. Miyawaki T,Kinoshita Y,Iizuka T.A case of Ollier's disease of the hand.Ann Plast Surg,1997,38(1):77-80.
5. Upton J,Glowacki J.Hand reconstruction with allograft demineralized bone:twenty-six implants in twelve patients.J Hand Surg (Am),1992,17(4):704-713.
6. Tordai P,Hoglund M,Lugnegård H.Is the treatment of enchondroma in the hand by simple curettage a rewarding method? J Hand Surg (Br),1990,15(3):331-334.
7. Hasselgren G,Forssblad P,Törnvall A.Bone grafting unnecessary in the treatment of enchondromas in the hand.J Hand Surg (Am),1991,16(1):139-142.
8. 杨勇,田文,李淳,等.单纯病灶刮除治疗手部内生软骨瘤的疗效分析.中华手外科杂志,2011,27(4):202-204.
9. 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.
10. Kim E,Miyake J,Kataoka T,et al.Corticoplasty for improved appearance of hands with Ollier disease.J Hand Surg (Am),2012,37(11):2294-2299.
11. Goto T,Yokokura S,Kawano H,et al.Simple curettage without bone grafting for enchondromata of the hand:with special reference to replacement of the cortical window.J Hand Surg (Br),2002,27(5):446-451.
12. Omokawa S,Tamai S,Takakura Y,et al.A long-term study of the donor-site ankle after vascularized fibula grafts in children.Microsurgery,1996,17(3):162-166.
13. Sekiya I,Matsui N,Otsuka T,et al.The treatment of enchondromas in the hand by endoscopic curettage without bone grafting.J Hand Surg (Br),1997,22(2):230-234.
14. 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.
15. Schwartz HS,Zimmerman NB,Simon MA,et al.The malignant potential of enchondromatosis.J Bone Joint Surg (Am),1987,69(2):269-274.
16. Liu J,Hudkins PG,Swee RG,et al.Bone sarcomas associated with Ollier's disease.Cancer,1987,59(7):1376-1385.

Chinese Journal of Reparative and Reconstructive Surgery

CORTICOPLASTY FOR MULTIPLE ENCHONDROMATOSIS OF HAND

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