Med Bull Sisli Etfal Hosp. 2022; 56(3): 400-407 | DOI: 10.14744/SEMB.2022.00483

Comparison of distal radius autograft technique with iliac crest autograft technique in solitary finger enchondramas

Osman Orman¹, Ibrahim Faruk Adiguzel¹, Ayse Sencan¹, Mehmet Baydar¹, Mujgan Orman², Alperen Ozturk^3
1Department of Hand Surgery, Metin Sabancý Baltalimaný Bone Research Hospital, Istanbul, Türkiye
²Department of Radiology, Medicana Ýnternational Hospital, Istanbul, Türkiye
³Department of Orthopaedic and Traumatology, Prof. Dr. Cemil Taþcýoðlu City Hospital, Istanbul, Türkiye

Objectives: The purpose of the study was to compare clinical and radiological outcomes of autografts obtained from the iliac crest (IC) and distal radius (DR) and to evaluate their superiority for surgical treatment of solitary finger enchondromas.
Methods: Twenty-five patients for whom curettage and autografting were carried out for finger enchondroma were retrospectively analyzed. DR autograft was used in eight patients and IC autograft was used in 17 patients. Data on pre-operative total active motion (TAM), disabilities of the arm, shoulder, and hand (DASH) score, and pain visual analog scale (VAS) scores of the involved finger, duration of surgery, amount of bleeding during the operation, length of hospital stay, presence of complications related to anesthesia, and post-operative donor site morbidity were obtained. Pre-operative and post-operative 12th month radiographies were evaluated for pre-operative tumor volume, post-operative remnant volume, and Tordai radiologic evaluation grade.
Results: No statistically significant difference could be identified between post-operative TAM (p=0.154), DASH (p=0.458), pain VAS scores (p=0.571), remnant volume (p=0.496), Tordai radiologic evaluation grade (p=0.522), duration of surgery (p=0.288), and amount of bleeding (p=0.114) between DR and IC groups. However, mean hospital stay duration was shorter for the DR group (p=0.0001). Recurrence was observed in one patient in the DR group and three patients in the IC group (p=0.996).
Conclusion: The clinical and radiological outcomes of grafting from the DR and IC were similar in the treatment of hand enchondromas. However, grafting from the DR may result in shorter hospital stay compared to IC grafting.

Keywords: Bone grafting, bone neoplasm, Local anesthesia, Pathological fracture

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Parmak enkondromlarýnda distal radiustan otogreftleme tekniðinin iliak kanat otogreftleme tekniðiyle karþýlaþtýrmasý

Osman Orman¹, Ibrahim Faruk Adiguzel¹, Ayse Sencan¹, Mehmet Baydar¹, Mujgan Orman², Alperen Ozturk^3
1Metin Sabancý Baltalimaný Kemik Hastalýklarý Eðitim ve Araþtýrma Hastanesi, El Cerrahisi Kliniði, Ýstanbul
²Medicana International Hastanesi, Radyoloji Bölümü, Ýstanbul
³Prof. Dr. Cemil Taþcýoðlu Þehir Hastanesi, Ortopedi ve Travmatoloji Kliniði, Ýstanbul

Soliter parmak enkondromlarýnýn cerrahi tedavisinde ilyak krestten (ÝK) ve distal radiustan (DR) elde edilen otogreftlerin klinik ve radyolojik sonuçlarýný karþýlaþtýrmak ve birbirlerine üstünlüklerini deðerlendirmek.
Metod
Parmak enkondromu nedeniyle küretaj ve otogreft uygulanan 25 hasta retrospektif olarak incelendi. Bu hastalarýn 8’inde DR otogrefti, 17’sinde ÝK otogrefti kullanýlmýþtý. Ameliyat öncesi toplam aktif eklem hareket açýklýðý (TAM), Disabilities of the arm, shoulder and hand (DASH) skoru ve etkilenen parmaðýn Visual Analogue Scale (VAS) skorlarý, ameliyat süresi, ameliyat sýrasýndaki kanama miktarý, hastanede kalýþ süresi, anesteziye baðlý komplikasyon varlýðý ve ameliyat sonrasý donör saha morbiditesine iliþkin veriler elde edildi. Ameliyat öncesi ve ameliyat sonrasý 12. ay radyografilerinde ameliyat öncesi tümör hacmi, ameliyat sonrasý lezyon kalan hacmi ve Tordai radyolojik deðerlendirmesi ölçüldü.
Bulgular
DR ve ÝK gruplarý arasýnda ameliyat sonrasý TAM (p=0,154), DASH (p=0,458), aðrý VAS skorlarý (p=0,571), kalan hacim (p=0,496), Tordai radyolojik deðerlendirme derecesi (p=0,522), ameliyat süresi (p=0,288) ve kanama miktarý (p=0,114) arasýnda istatistiksel olarak anlamlý fark saptanmadý. Ancak ortalama hastanede kalýþ süresi DR grubunda daha kýsaydý (p=0.0001). DR grubunda 1 hastada ve ÝK grubunda 3 hastada nüks gözlendi (p=0,996).
Sonuç
El parmak enkondromlarýnýn tedavisinde, DR ve ÝK'den greftlemenin klinik ve radyolojik sonuçlarý benzerdi. Bununla birlikte, DR'den greftlemede, ÝK greftlemeye göre daha kýsa hastane kalýþ süresini sahipti. (SETB-2021-12-366)

Anahtar Kelimeler: Kemik greftleme, kemik neoplazileri, lokal anestezi, patolojik kýrýk

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