Enchondroma of the Hand: Result of Surgery Curettage and Grafting and Possible Factors Affecting the Outcome: 手部內生性軟骨瘤 - 外科刮除術的結果和可能影響結果的因素

A retrospective review for enchondroma in the hand which had undergone operative treatment is presented. Twenty patients were treated operatively over a 10-year period. A total of 70% of the patients presented with pathological fracture. Enchondromas were most commonly located in the little finger (65%) and proximal phalange (60%). Enchondromas presented with pathological fractures and were treated definitively after the fracture had healed, except for one patient with open reduction, internal fixation of fracture, and bone grafting. All 20 patients underwent curettage of the enchondroma. In the same operative occasion, 16 patients received bone grafting, three patients received bone substitutes, and one had received bone cement. Fourteen (70%) of the patients suffered no major postoperative complications. Postoperative stiffness was encountered in seven patients. A secondary operation for relief of postoperative stiffness was performed in three patients. Factors were assessed for their risk of resulting in postoperative stiffness and occurrence of secondary operation. Factors included sex, age, pathological fracture, location of lesion, and preoperative stiffness. Only preoperative stiffness was a statistically significant risk factor contributing to postoperative stiffness and occurrence of a secondary operation.

中 文 摘 要這是一個關於用外科刮除術來治療手部內生性軟骨瘤的回顧性研究。在10年內有20例患者接受手術治療。當中70%病例呈現病理性骨折。內生性軟骨瘤最常是位於小指(65%)和近端指骨(60%)。除了一個接受了開放性復位、內固定和自體骨移植的病例之外,所有呈現病理性骨折的病例都是在骨折愈合後才進行骨瘤治療。所有20名患者都接受了經歷了外科刮除術。當中16例接受了骨移植,3例接受了人工骨,1例接受了骨水泥。十四例(70%)沒有重大術後併發症。7例出現術後關節僵硬,當中 3例因而要進行第二次手術。我們評估了可能導致術後僵硬和需要進行第二次手術的各樣風險因素,包括性別、年齡、骨瘤的位置和術前的關節僵硬程度等。我們發現只有術前的關節僵硬程度是達到統計學上意義的風險因素。