Modified technique for one-stage treatment of proximal phalangeal enchondromas with pathologic fractures
Huaiyuan Zheng1, Juan Liu1, Xinyi Dai1
1Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China; Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
Purpose:
To evaluate the treatment outcome for enchondromas of the proximal phalanx with pathological fracture.
Methods:
Between June 2008 and October 2012, we treated 9 patients with solitary proximal phalanx enchondromas and pathologic fractures by curetting the tumor, filling the void with a block of autogenous bone chip, and applying a low-profile miniplate. Postoperative follow-up included clinical assessment, pain evaluation, and radiographs.
Results:
Follow-up time ranged from 13 to 42 months (mean, 30 mo). No major complications such as notable malalignment, nonunion, infection, or tumor recurrence were observed. All fractures healed after a mean of 8 weeks postoperatively. Full motion was achieved in 5 patients and extension lag (5° to 10°) of the proximal interphalangeal joint persisted in 4. Function was excellent in all patients according to the Takigawa criteria. All patients reported they were pain free and had resumed presurgical function within 12 weeks after surgery.
Conclusions:
Tumor curettage, reconstruction of the bone defect with a block of autogenous bone chip, and low-profile miniplate fixation provided one-stage treatment with immediate rigid stabilization and good functional outcomes.
Type Of Study/Level Of Evidence:
Therapeutic IV.
