| Objective:To analyze the clinical effect of autogenous iliac bone graft and allograft in the treatment of metacarpal and phalangeal bone enchondroma.Methods:The data of patients who underwent surgical treatment for metacarpal and phalangeal bone enchondroma in the Department of Orthopedics,The Second Hospital of Shanxi Medical University from January 2015 to December 2020 were retrospectively analyzed.A total of 34 patients(39 sites)were included in this study,including 8 patients(8 sites)with pathological fracture.All included patients were filled with autogenous iliac bone or allograft bone after the curettage of the lesion,and statistically analyzed by grouping of donor bone sources.Visual Analogue Score(VAS)was used to compare the pain levels of the two groups on the first postoperative day.The recovery time of the maximum range of motion and the recovery of hand function at the last follow-up were compared between the two groups.In addition,the effects of combination of pathological fracture and early functional exercise on the recovery of hand function at the last follow-up were also analyzed.Results:All patients were followed up for 4 to 47 months,with a mean follow-up time of13.7 months.All patients with pathologic fractures healed.Two patients with autogenous iliac bone grafts developed donor site complications,including hypoesthesia and chronic pain at the donor site.The VAS score on the first day after surgery was(2.66±0.49,2.95±0.67,P=0.184),and the time to recover the maximum range of motion was(48.75±11.03 days,46.08±14.69 days,P=0.543)in the autogenous iliac bone graft group and the allograft group,which was not statistically significant.At the last follow-up,there was no statistical significance in the scores of activity(P= 0.616),sensation(P=0.404),appearance(P=0.132),working ability(P=0.66)and hand function score(P= 0.674)between the two groups.A patient with a pathological fracture of the proximal left index finger did not follow the instructions for functional exercise,and almost completely lost the movement ability of metacarpophalangeal joint and proximal interphalangeal joint,and was forced to resign from his previous job.Conclusion:Both autogenous iliac bone grafts and allograft bone grafts can achieve satisfactory results in the treatment of metacarpal and phalangeal bone enchondromas of the hand,but we should be aware of the complications of autogenous iliac bone grafts at the donor site. |
