Enchondroma in the distal phalanx of the finger: An observational study of 34 cases in a single institution

Abstract

The goal of our study was to report the clinical presentation, treatment, and complications of enchondroma in the distal phalanx of the finger. This was a retrospective study of 34 patients (19 women and 15 men) who underwent surgery between May 2004 and September 2012 for enchondroma in the distal phalanx of the finger. The average age of the patients was 39.38 ± 10.97 years old (range 14-59). The presenting symptoms and imaging features were recorded. The surgical procedure was performed under regional or general anesthesia. The surgical technique involved removal of tumors by opening a cortical window and curetting the cavity. The defects were filled with an injectable calcium phosphate cement. All patients received follow-up in our outpatient clinic every 6 months. Expansion of bone or thinning of the cortex present in the radiological imaging, including anteroposterior and lateral plain radiographs of the fingers, was used to assess for tumor recurrence. The observational end-point was reoperation.All tumors were confirmed as enchondromas by the pathological results. None of the patients had a tumor recurrence. Three patients (9% of cases) developed an infection. After antibiotic treatment, 2 patients were cured, and 1 patient required an amputation. Enchondroma in the distal phalanx of the finger presents with a variety of clinical symptoms. Injectable calcium phosphate cement is adequate for bone grafting. Postoperative infection is more common than tumor recurrence. If patients have an infection or bilateral bone cortex defects, bone grafting is challenging.

Level of evidence: Therapeutic study, Level IV.

Figure 1

Patient examples are presented with the different initial symptoms (A) clubbing finger deformity and (B) mallet finger deformity.

Figure 2

These images show enchondroma in the distal phalanx of the finger. (A, B) The preoperative CT shows bilateral bone cortex defects. CT = computed tomography.

Figure 3

These images show enchondroma in the distal phalanx of the finger. (A, B) A T2-weighted MRI image shows an enchondroma with hypersignal intensity, with the tumor invading the soft tissue leading to an infection of the whole finger.

Figure 4

These images show a 51-year-old male with an enchondroma in his distal ring finger. (A, B) Preoperative radiography and (C, D) 1-year postoperative radiography after tumor curettage with a calcium phosphate cement graft shows bone union and no tumor recurrence.