Fracture through the stalk of pedunculated osteochondromas. A report of three cases

Although fracture through the base of an osteochondroma is a well-recognized clinical entity, the fate of such fractures has never been documented. Recommendations concerning the treatment of these fractures are contradictory. Of the three cases of fracture through the base of a pedunculated osteochondroma observed in the last 12 years, two healed without problem, one in a patient with a solitary osteochondroma, the other in a patient with multiple osteochondromas. The third patient remained symptomatic one year after injury, and histologic evaluation of the specimen after surgical excision confirmed the diagnosis of fibrous nonunion of the fracture. Experience with fractures through the base of a pedunculated osteochondroma suggests that the majority of these fractures will heal without complication, regardless of whether they involve solitary or multiple osteochondromas. However, symptomatic fibrous nonunion of such a fracture may occur particularly when an osteochondroma is located near large, mobile tendons.