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Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach

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Management of the Hand Tumors.

N K Datta¹, K P Das, P K Aish

¹Professor Dr Nakul Kumar Datta, Ex-Chairman, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;

Mymensingh Medical Journal : MMJ

|January 3, 2023

Summary

Hand tumors are uncommon, with 95% being benign. This study analyzed 220 hand tumors, finding 86% benign and 14% malignant, emphasizing early diagnosis and management for better outcomes.

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Area of Science:

Orthopaedic Surgery
Oncology
Hand Surgery

Background:

Hand tumors are rare, with distinct growth patterns and metastatic potential.
Secondary metastatic tumors to the hand are exceptionally uncommon (0.1%).
Diagnosis relies on clinical assessment, aided by imaging like X-ray, ultrasonography (USG), and magnetic resonance imaging (MRI).

Purpose of the Study:

To investigate the early diagnosis, epidemiological patterns, and optimal management strategies for hand tumors.
To evaluate factors influencing hand function following tumor treatment.
To improve prognosis and survival rates for patients with hand and upper limb tumors.

Main Methods:

A prospective study conducted from January 2004 to July 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Inclusion of 220 patients diagnosed with hand tumors in the hand unit.
Data collection focused on tumor type, patient demographics, diagnostic methods, treatment, and outcomes.

Main Results:

Out of 220 hand tumors, 190 (86.36%) were benign or tumor-like lesions, and 30 (13.64%) were malignant.
Benign bone tumors included Enchondroma and Giant Cell Tumors; common benign soft tissue tumors were Giant Cell Tumors of Tendon Sheath, Glomus Tumors, Hemangiomas, Neurofibromas, and Schwannomas.
Malignant tumors included Synovial Sarcoma (33.33%), Fibrosarcoma (13.33%), Osteosarcoma (10%), and Chondrosarcoma (10%).
Most benign lesions resolved post-excision, while malignant tumors required multimodal treatment (surgery, chemotherapy, radiotherapy), with some cases necessitating referral or resulting in metastasis.

Conclusions:

Hand tumors, though uncommon, require prompt diagnosis and intervention for favorable outcomes, especially malignant types.
Effective management of malignant hand tumors is challenging, often requiring amputation and a multidisciplinary approach.
Early detection and appropriate treatment are crucial for preserving hand function and improving survival in patients with hand tumors.