Curettage of benign bone tumors without grafts gives sufficient bone strength

Yanagawa, Takashi; Watanabe, Hideomi; Shinozaki, Tetsuya; Takagishi, Kenji

doi:10.1080/17453670902804604

Cited by 51 publications

(47 citation statements)

References 30 publications

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“…Finally, some surgeons do not reconstruct the remaining tumour cavity and suggest that curettage alone is sufficient enough to treat enchondroma of the hand [12,30]. However, curettage alone leaves a thin cortical shell, easy to collapse during daily activities, if it is left without protection [33,34]. Patients with grade I chondrosarcomas and enchondromas can have similar radiographic findings including endosteal scalloping, increased uptake of the radiotracer on the bone scan and similar histology abnormality [20,22].…”

Section: Discussionmentioning

confidence: 99%

Phenolization and Coralline Hydroxyapatite Grafting following Meticulous Curettage for the Treatment of Enchondroma of the Hand. A Case Series of 82 Patients with 5-year Follow-up

Georgiannos

Lampridis

Bisbinas

2014

Hand (New York, N,Y.)

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Background Enchondromas are benign cartilaginous tumours. The most common location is in the long bones of the hand. Treatment methods fall into a broad spectrum ranging from conservative, medical therapies, to a variety of surgical procedures, which may or may not employ the use of local adjuvant treatment or bone grafting. The purpose of this study was to report our experience and evaluate the longterm results of patients with enchondroma of the hand, treated in our department with meticulous curettage, phenolization and coralline hydroxyapatite grafting. Methods We present 82 patients with hand enchondromas treated surgically in our department during the last 10 years. The patients were treated operatively with meticulous curettage of the bone lesion, with use of phenol 5 % as local adjuvant and coralline hydroxyapatite bone graft to fill in the remaining cavity. Results At a minimum of 5-year follow-up, radiographs and clinical examination showed adequate bone formation at the site of enchondroma excavation and no evidence of recurrence, fracture, infection or other complication related to the procedure. Conclusion We concluded that the combination of meticulous curettage of the lesion, with the use of phenol as local adjuvant and coralline hydroxyapatite graft is a safe technique that prevents recurrence and allows adequate and uncomplicated local new bone formation.

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Section: Discussionmentioning

confidence: 99%

Phenolization and Coralline Hydroxyapatite Grafting following Meticulous Curettage for the Treatment of Enchondroma of the Hand. A Case Series of 82 Patients with 5-year Follow-up

Georgiannos

Lampridis

Bisbinas

2014

Hand (New York, N,Y.)

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“…Surgery is indicated only for confirmation biopsy, correction of deformities, non-operative therapy failure, prevention of pathological changes, and/or eradication of symptomatic lesions 1, 9, 10, 11. In cases of fractures, the treatment can be done with closed fixation.…”

Section: Discussionmentioning

confidence: 99%

Monostotic fibrous dysplasia of the metacarpal: a case report

Batista¹,

Araújo²,

Schwartzman³

2016

Revista Brasileira de Ortopedia (English Edition)

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Fibrous dysplasia is a bone disease characterized by abnormal differentiation of fibrous tissue in the bones; it is often asymptomatic. It may affect one bone (monostotic) or several bones (polyostotic). The monostotic form primarily affects the ribs, but hardly ever affects the hand. It is important to make the differential diagnosis with malignant bone tumors. This article describes the treatment and outcome of a rare case of a patient admitted with a history of tumor growth in the right hand, diagnosed as fibrous dysplasia of the right second metacarpal. Male patient, 14 years of age, admitted to the Sarah Hospital with lesion on the dorsum of the right hand without pain complaints, previous history of trauma, nor local signs of inflammation. Physical examination revealed swelling on the dorsum of the second metacarpal, painless, with unaltered mobility and sensitivity. Radiography, computed tomography, and magnetic resonance imaging indicated the involvement of the entire length of the second metacarpal: only the distal epiphysis was preserved, with areas of bone lysis. After biopsy confirmation, the patient underwent surgery, using a long cortical graft for reconstructing the metacarpal. During the follow-up period of five years there were no signs of recurrence, and proper digital growth and functionality of the operated hand were observed.

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“…However, obtaining sufficient bone for large cavities may be difficult and sequelae may be generated at the donor site. In addition, certain authors have recommended curettage of benign bone tumors without grafts (17). We recommend curettage and grafting with autogenous bone from the ilium.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary nailing for fibrous dysplasia of lower limbs

et al. 2012

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Abstract. Fibrous dysplasia (FD) of the bone is rare and self-limiting. However, lesion expansion may occur, causing pain, deformity and pathological fracture, in which case surgery is occasionally required. Indicators of FD have not been previously described, although there are several surgical procedures reported (curettage, curettage and graft, and internal fixation). In this study we discuss whether intramedullary nailing of these lesions could result in more favorable outcomes in correcting deformities, including the prevention of secondary fractures and maintenance of the bone, compared to other internal fixation methods. A total of 39 patients with FD of the bone treated with intramedullary nailing were retrospectively analyzed. The surgical procedures involved curettage, grafting and intramedullary nailing. No infection, thromboembolism or other notable complications occurred. The patients resumed full activities of daily living. At the last follow-up, 33 patients presented no pain and seven patients had occasional mild pain. The clinical score according to the modified criteria of Guille improved from an average of 4.4 points prior to surgery to an average of 8 points following surgery. The neck shaft angle of the femur improved from an average of 90˚ prior to surgery to 125˚ following surgery. Intramedullary nailing may be used to correct deformity and prevent pain and refracture in FD of the bone of the lower limbs with large lesions, pathological fracture or deformities. All patients were allowed full athletic recovery following surgery.

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Curettage of benign bone tumors without grafts gives sufficient bone strength

Cited by 51 publications

References 30 publications

Phenolization and Coralline Hydroxyapatite Grafting following Meticulous Curettage for the Treatment of Enchondroma of the Hand. A Case Series of 82 Patients with 5-year Follow-up

Phenolization and Coralline Hydroxyapatite Grafting following Meticulous Curettage for the Treatment of Enchondroma of the Hand. A Case Series of 82 Patients with 5-year Follow-up

Monostotic fibrous dysplasia of the metacarpal: a case report

Intramedullary nailing for fibrous dysplasia of lower limbs

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