Retrospectively Analyse The Therapeutic Effect Of Enchondroma Of The Hand

Objective:To retrospective analyse of clinical characteristics of the disease,diagnosis and treatment of enchondroma of the hand.To discuss the risk factors for postoperative recovery of enchondroma of the hand.To summarize the characteristics of the disesase and therap experience of enchondroma of the hand and provide beneficial reference for clinical diagnosis and therap.Methods:To retrospective analysis of the 53 cases of enchondroma of the hand admitted to our hospital from January 2012 to June 2016,which were confirmed by pathology and accept the surgical treatment,to statistical analysis the dangerous factors which affect postoperative recovery.Gender,age,single and multiple,involvement site,tumor volume,combined with pathological fracture and material of bone grafting as 7variables.Statistical analysis of the excellent rate of internal fixation in patients for enchondroma combined pathological fracture of hand,include plate and screw,Kirschner wire fixation,to analyze the effect of internal fixation on postoperative effect.The factors influencing the outcome of enchondroma of hand were divided into two groups,and the chi-square test was used to analyze the variables.The functional evaluation were assessed by applying Kazwcki’s evaluation standard of enchondroma of the hand,divided into good and poor.These two results are dependent variables.P<0.05 has statistical significance.Results10-40 years old patients are more common in 53 cases of enchondroma of the hand patients.Male patients with slightly more than female patients;There is no obvious abnormalities for male and female in the onset of the disease.Multiple enchondroma 12 cases,accounting for22.64%,there is a maximum of 3 locations in one patient;proximal phalanx involved most common,secondly the metacarpal and followed by middle phalanx,less hair in the distal phalanx;There are 23 cases enchondroma combined with pathological fractures in all patients,accounting for 44.40%.The follow-up period from 3 months to 36 months,with an average follow-up of 15 months.4-6 weeks after surgery and every six months review X-ray film,no recurrence and malignancy.The functional evaluation were assessed by applying Kazwcki’s evaluation standard of enchondroma of the hand,the results were 31 cases excellent,accounting for 58.49%,13 cases good,accounting for24.53%,7 cases moderate,accounting for 13.21%,2 cases poor,accounting for 3.77%.The excellent and good rate for 83.02% in all patients.6 case had no bone graft,excellent rate of 100%;29 case had allogenei bone graft,excellent rate of 79.31%;18 case autologous bone graft,excellent rate of 83.33%.23 case of enchondroma complicated with pathological fractures of the hand: Pathological fractures with Kirschner wire fixation implantation in 17 cases,accounting for 73.91%,excellent rate of 64.71%.Pathological fractures with plate and screw implantation in 6 cases,accounting for 26.09%,excellent rate of 83.33%.Obtained through the statistical methods(spss21.0 software),we found the result of surgical treatment was related to the enchondroma combined with pathological fractures(P=0.022).There was no statistical significance in the way of bone grafting,but the effect of allogeneic bone was better,the trauma and the postoperative complications were less.There was no significant difference between the two fixation methods.Kirschner wire fixation fasten fracture secyrely,can save another operation.We recommend fixing with Kirschner wire.Conclusion Enchondroma of the hand is the most common bone tumor and the most destructive bone tumor in the hand,occurs commonly in the 10-40 year old patients.There is no significant difference in gender ratio.The diagnosis of enchondroma in the hand mainly depends on X-ray examination,CT and MRI on the early detection and diagnosis of cancer has important guiding value.Need to pay attention to bone cysts,osteoid osteoma,primary osteosarcoma,Ollier disease phase identification.The Postoperative functional of hand is related to the pathological fractures.Recommended treatment with tumor curettage and allogeneic bone graft for enchondroma and the way of internal fixation with Kirschner wire for the enchondroma combined with pathological fractures,early functional exercise.