Elin enkondromları: 33 vakanın retrospektif değerlendirilmesi

Amaç: İzole küretaj ya da küretaj ve greftleme ile tedavi edilmiş elin enkondromlarının demografik değerlendirmesini ve dağılımlarını sunmak. Gereç ve Yöntemler: 2007-2019 yılları arasında el tümörü nedeniyle opere edilen ve patolojik tanısı aynı hastanede konulan 798 hasta retrospektif olarak değerlendirildi. Enkondroma tanısı konulan ve bu sebeple opere edilen, en az bir yıl süre ile takip edilen hastaların yaşı, cinsiyeti, etkilenen tarafları ve tümör yerleşimi değerlendirildi. Bulgular: Toplam 33 hasta ve onların 34 elde yerleşen enkondroması dahil edildi (Ortalama 36,4 yıl; 6-77 aralığında). 33 hastanın 15’i (%45) erkek, 18’i (%55) kadındı. 33 hastanın 20’sinin (%61) enkondroması sağ elde, 13’ününki (%39) sol elde yerleşimliydi. Bir hastanın (%3) iki parmağında enkondroma mevcuttu. 17 hastanın (%52) enkondroması proksimal falanksta, yedi hastanınki (%21) orta falanksta, yedi hastanın (%21) distal falanksta (toplam sekiz distal falanks) ve iki hastanınki (%6) metakarplarındaydı. Bir hastanın enkondroması (%3) başparmakta, altı hastanınki (%18.2) 2.parmakta, beş hastanınki (%15,1) 3.parmakta, 11 hastanınki (%33,3) 4.parmakta ve dokuz hastanınki (%27,3) ise 5.parmakta idi. Sonuç: Enkondromlar genellikle sağ elin ulnar tarafında, sıklıkla proksimal falankslarda görülür ve patolojik kırıklara sebep olabilir.

Anahtar Kelimeler:

Enkondrom, Elin enkondromu, El, El tümörleri, Tümör

Enchondromas of the hand: Retrospective evaluation of 33 cases

Aim: To present the demographic evaluation and distribution of the enchondromas of the hand which were treated by curettage with bone grafting or isolated curettage. Material and Methods: We retrospectively evaluated the 798 patients who were operated because of hand tumors and pathological diagnosis was made in the same hospital between 2007 and 2019. Age, gender, affected side and location of the tumor of the patients who were diagnosed with enchondroma of the hand and could be follow-up minimum of one year were evaluated accordingly. Results: A total of 33 patients (mean age 36.4 years; range 6 to 77 years) with 34 enchondromas of the hand were included. Fifteen (45%) out of 33 patients were male and 18 (55%) were female. Twenty (61%) out of 33 had enchondroma on the right hand and 13 (39%) had on the left. One patient (3%) had enchondroma on his two fingers. Seventeen (52%) patients had enchondromas on their proximal phalanges, seven (21%) had on the middle phalanges, seven (21%) had on the distal phalanges (Total eight distal phalanges) and two (6%) had on metacarpals. One patient (3%) had enchondroma on her thumb, six (18.2%) had on the index finger, five (15.1%) had on the third finger, 11 (33.3%) had on the ring finger and nine patients (27.3%) had enchondromas on their little finger. Conclusion: Enchondromas are usually seen on the ulnar side of the right hand and frequently seen on the proximal phalanges and may cause pathological fractures.

Keywords:

enchondroma, enchondroma of the hand, hand, hand tumors, tumor,

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1. Lubahn JD, Bachoura A. Enchondroma of the Hand: Evaluation and Management. J Am Acad Orthop Surg 2016; 24: 625-33.
2. Bachoura A, Rice IS, Lubahn AR, Lubahn JD. The surgical management of hand enchondroma without postcurettage void augmentation: authors' experience and a systematic review. Hand (N Y) 2015; 10: 461-71.
3. Hsu CS, Hentz VR, Yao J. Tumours of the hand. Lancet Oncol 2007; 8: 157-66.
4. Gaulke R. The distribution of solitary enchondromata at the hand. J Hand Surg Br 2002; 27: 444-5.
5. Tang C, Chan M, Fok M, Fung B. Current management of hand enchondroma: a review. Hand Surg 2015; 20: 191-5.
6. Miwa S, Okamoto H, Yamada S, et al. Distribution of Solitary and Multiple Enchondromas of the Hand. In Vivo 2019; 33: 2235-40.
7. Sassoon AA, Fitz-Gibbon PD, Harmsen WS, Moran SL. Enchondromas of the hand: factors affecting recurrence, healing, motion, and malignant transformation. J Hand Surg Am 2012; 37: 1229-34.
8. Cavit A, Özcanli H, Sançmiş M, Ocak GA, Gürer Eİ. Tumorous Conditions of the Hand: A Retrospective Review of 402 Cases. Turk Patoloji Derg 2018; 34: 66-72.
9. Civan O, Cavit A, Pota K, Özcanlı H. Tumorous conditions of the pediatric hand and wrist: Ten-year experience of a single center. Jt Dis Relat Surg 2020; 31: 341-5.
10. Sağlık Y, Atalar H, Armangil M, Başarır K, Yıldız Y, Bilgin S. Management of tumors and tumor-like lesions of the hand: a review of 191 patients. Eklem Hastalik Cerrahisi 2013; 24: 149-55.
11. Sollaci C, Araújo GCS. Enchondromas of the Hand: A 20-year Experience. Rev Bras Ortop (Sao Paulo) 2019; 54: 714-20.
12. Figl M, Leixnering M. Retrospective review of outcome after surgical treatment of enchondromas in the hand. Arch Orthop Trauma Surg 2009; 129: 729-34.
13. Cha SM, Shin HD, Kim KC, Park IY. Extensive curettage using a high-speed burr versus dehydrated alcohol instillation for the treatment of enchondroma of the hand. J Hand Surg Eur Vol 2015; 40: 384-91.
14. Çapkin S, Cavit A, Yilmaz K, Kaleli T. Surgical Treatment of Solitary Enchondromas of the Hand. Cureus 2020; 12: 7497.