Pathologic Fractures in Benign Neoplasms of the Fingers

Abstract

Background: To describe the rate and predictors of pathologic fractures in benign neoplasms of the finger, as variables from prediction models for pathologic fractures of the long bones of the extremities are not necessarily applicable to the bones of the hand. Methods: In this retrospective chart review, 69 histologically confirmed neoplasms affecting the bones of the fingers, 49 phalanges and 20 metacarpals, were identified in patients presenting at 2 urban hospitals over a 24-year period. Different variables were studied as possible predictors of pathologic fractures. Results: Forty-nine percent of the tumors presented as a pathologic fracture. The small finger was independently associated with pathologic fractures compared to the other fingers. Tumors of the metacarpal bones were the least likely to fracture compared to other bones. Conclusions: Almost half of neoplasms affecting the bones of the fingers presented initially with a pathologic fracture, most commonly the small finger. Therefore, a lower threshold for surgical treatment of a bone neoplasm affecting the small finger may be reasonable.

Pathological mallet finger due to distal phalanx enchondroma: a case report

“…The benign tumor can be diagnosed using standard radiography because of the typical expansile lytic lesion with cortical thinning. [1][2][3] Shimizu et al 4 examined five patients with enchondroma of the distal phalanx, of whom three patients had pathological fractures caused by minor trauma, and the other two patients were diagnosed with clubbing deformity. The fracture was immobilized by splint, and the tumor was excised after union of the fracture in the distal phalanx.…”

“…Rupture and avulsion in flexor or extensor tendons can occur because of tendon connections in the last phalanx of the fingers. The benign tumor can be diagnosed using standard radiography because of the typical expansile lytic lesion with cortical thinning 1–3. Shimizu et al 4.…”

“…Enchondroma is a benign tumor that develops in the proximal part of the fingers and is one of the most frequent primary and destructive tumors of the hand. The metacarpals and middle phalanx are the other most affected parts 1. Because there are no distinct clinical symptoms, it is sometimes not identified until a pathological fracture occurs.…”

“…The metacarpals and middle phalanx are the other most affected parts. 1 Because there are no distinct clinical symptoms, it is sometimes not identified until a pathological fracture occurs. Enchondroma begins as a nidus of cartilaginous cells in the physis, arises in the medullary cavity and grows outward into the cortex, eventually growing into an endogenous mass in the bone.…”

“…Enchondroma begins as a nidus of cartilaginous cells in the physis, arises in the medullary cavity and grows outward into the cortex, eventually growing into an endogenous mass in the bone. [1][2][3] One therapeutic obstacle is a pathological fracture and its consequences in the distal phalanx because the extensor mechanism in the distal half has failed concurrently. 3 This study discusses a case of mallet finger that was caused by a pathological fracture due to enchondroma.…”