Enchondroma of Hands: A Surgical Dilemma and Our Experience

Enchondroma is the most common benign cartilaginous tumor of the small tubular bones of the hand. Although typically indolent, it may present with pain, swelling, or pathological fracture, and requires careful differentiation from low-grade chondrosarcoma. Management strategies range from observation in asymptomatic cases to surgical curettage with or without grafting in symptomatic lesions.

We present three cases of hand enchondroma involving the phalanges in patients aged 20-37 years. Clinical features included fusiform swelling, pain, and, in one case, pathological fracture. Radiographs showed well-circumscribed lytic lesions with chondroid matrix. All cases were treated with intralesional curettage, cavity filling with cancellous autograft harvested from the olecranon, and prophylactic K-wire fixation. Histopathology confirmed enchondroma in each case. Postoperatively, patients underwent short-term immobilization followed by physiotherapy. At 12 weeks, all achieved full functional recovery with radiological consolidation and no recurrence or complications.

Enchondroma of the hand, though benign, requires timely recognition and appropriate surgical management. Curettage with autologous bone grafting and prophylactic fixation offers reliable outcomes with minimal morbidity, while early mobilization reduces the risk of post-operative stiffness, even in cases with pathological fracture.