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Endoscopic Cholesteatoma Surgery
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Endoscopically assisted excision of digital enchondroma.

Jeffrey F Dietz1, Sergey M Kachar, Daniel J Nagle

  • 1Department of Orthopaedics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 USA. j-dietz@md.northwestern.edu

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|June 15, 2007
PubMed
Summary

Endoscopically assisted curettage improves hand enchondroma treatment by enabling direct visualization for thorough tumor removal. This minimally invasive technique may reduce recurrence rates and improve patient outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Minimally Invasive Procedures

Background:

  • Enchondromas are common benign bone tumors, often affecting the hand.
  • Traditional open curettage can be limited by visualization and may lead to incomplete removal.
  • Recurrence of enchondromas can necessitate further surgical intervention.

Purpose of the Study:

  • To evaluate the efficacy and advantages of endoscopically assisted curettage for hand enchondromas.
  • To compare this technique with traditional open curettage.
  • To assess the potential for reduced morbidity and recurrence.

Main Methods:

  • Two cases of enchondroma of the hand treated with endoscopically assisted curettage.
  • Initial open curettage followed by arthroscopic insertion (1.9-mm scope) through a cortical window.

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  • Arthroscopic visualization, saline lavage, suction, and demineralized bone matrix (DBX) grafting.

    • Main Results:

    • Direct visualization allowed accurate assessment of tumor extent and curettage adequacy.
    • Reduced need for aggressive, blind curette passes, potentially minimizing cortical violation.
    • Complete clearance of the medullary canal was facilitated by the endoscopic approach.

    Conclusions:

    • Endoscopically assisted curettage offers advantages over open curettage alone for hand enchondromas.
    • This technique provides enhanced visualization, potentially reducing recurrence rates.
    • It is an inexpensive modification that may save time, decrease morbidity, and improve long-term outcomes.