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Surgical Treatment of Enchondromas of the Hand During Childhood in Ollier Disease

Abstract : Purpose: The objective of the present study was to evaluate the outcome of surgical treatment of hand lesions in Ollier disease (OD) carried out during childhood. Methods: A retrospective review was carried out of 10 pediatric patients with hand involvement of OD, who had undergone surgery for metacarpal or phalangeal enchondromas. The technique comprised curettage and cortical bone reconstruction with corticoplasty, to restore a near-normal phalangeal volume. The range of finger motion (pulp-to-palm distance), the shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire score, cosmetic improvement, radiological findings (according to Tordai's classification), and recurrence were recorded after a mean follow-up of 7.5 years (range, 4-11.3 years). Results: The mean age at surgery was 10.7 years (range, 6-14 years). Curettage was performed on 35 enchondromas, and 9 cavities were filled with a bone graft. The mean pulp-to-palm distance was significantly lower after surgery (from 1.5 cm to 0.25 cm; P < .05). The mean QuickDASH score was 3.84 (range, 0-11.4). A marked cosmetic improvement was noted for 83% of the hands. Three enchondromas recurred in 1 patient, requiring a second curettage. Fifty-seven percent of the cavities were completely filled with bone (Tordai stage 1) at last follow-up. The outcome did not depend on the presence or absence of a bone graft. Conclusions: Our results suggest that early surgical treatment comprising curettage and corticoplasty leads to good clinical, cosmetic, and radiological outcomes. Early surgical treatment of well-developed and/or symptomatic enchondromas of the hand in OD should be considered.
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Soumis le : vendredi 30 septembre 2022 - 15:34:12
Dernière modification le : samedi 1 octobre 2022 - 03:09:07




Céline Klein, Tiphanie Delcourt, Arielle Salon, Georges Finidori, Christophe Glorion, et al.. Surgical Treatment of Enchondromas of the Hand During Childhood in Ollier Disease. Journal of Hand Surgery (American Volume), 2018, 43 (10), pp.946.e1-946.e5. ⟨10.1016/j.jhsa.2018.02.010⟩. ⟨hal-03792984⟩



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