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. 2020 Mar;48(3):300060519892367.
doi: 10.1177/0300060519892367. Epub 2019 Dec 19.

A bent needle tip during irrigation for enchondroma of the distal phalanx: a new curettage tool

Eiji Osaka  1 , Toshio Kojima  1 , Yukihiro Yoshida  1 , Hiroshi Uei  1   2
Affiliations

A bent needle tip during irrigation for enchondroma of the distal phalanx: a new curettage tool

Eiji Osaka et al. J Int Med Res. 2020 Mar.

Abstract

Background: We employed a novel curettage tool, a bent needle tip, during irrigation for enchondroma of the distal phalanx. This study aimed to evaluate our new curettage tool for treating enchondroma of the distal phalanx.

Methods: Seven distal phalanx enchondromas were pathologically diagnosed at our institute. We evaluated age, gender, tumor location, affected side, clinical symptoms, Takigawa classification, size, recurrence, complications, residual pain, Tordai score, and follow-up period. We bent an 18G needle tip connected to an extension tube and syringe. The bent needle was inserted through the small hole, and the cavity for bone grafting was adequately filled with injectable calcium phosphate cement through the small hole.

Results: There were five centric-type and two giant-type tumors, with a mean size of 52.7%. All patients had clinical symptoms at the initial presentation. All patients showed complete bone healing within 3 months on post-radiological examinations and were Grade 1 according to the Tordai score.

Conclusions: This tool is extremely simple, and both the incision and the cortical window can be small. We recommend a bent needle tip, easily devised in any hospital, as a curettage tool for treating enchondroma in small bones, especially of the distal phalanx.

Keywords: Enchondroma; benign tumor curettage; bent needle tip; distal phalanx; finger tumor; novel curettage tool.

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Figures

Figure 1.
Figure 1.
Anatomy of the distal phalanx. The distal phalanx is a very small bone, and the proximal site of the distal phalanx has flexor and extensor tendon attachments.
Figure 2.
Figure 2.
A new curettage tool. Needle tip views; (a) frontal view, (b) lateral view, (c) oblique view, (d) overview of the curettage tool. An 18G needle tip was bent and then connected to an extension tube and a 50-mL syringe filled with saline, (e) saline in the tube is used for washing the cavity.
Figure 3.
Figure 3.
The size of an enchondroma was calculated from the frontal view of a plain radiograph as the percentage of the longitudinal axis of the distal phalanx that occupied the lytic area of the enchondroma.
Figure 4.
Figure 4.
Intraoperative findings. A small hole is made in the cortex with 2.0 K-wire. A bent needle is then inserted through the small hole.
Figure 5.
Figure 5.
(a) Pre-operative radiographic images. (b) Post-operative radiographic images. After full curettage, the cavity is adequately filled with injectable calcium phosphate cement for bone grafting.
See this image and copyright information in PMC

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