Bone Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Bone Cancer, including details on symptoms, types, treatment.

Endoscopically assisted excision of digital enchondroma.

Dietz JF, Kachar SM, Nagle DJ

Department of Orthopaedics, Northwestern University Feinberg School of Medicine, Chicago, IL 60611 USA. j-dietz@md.northwestern.edu

We present 2 cases of endoscopically assisted curettage of enchondroma of the hand. After initial open curettage of the lesion, a 1.9-mm arthroscope was introduced through a small cortical window. Under arthroscopic guidance, residual pathologic material was freed from the cavity wall and evacuated with the aid of repeated saline lavage combined with suction. The saline was injected through an 18-gauge angiocatheter under direct endoscopic control. The endoscope was then used to observe the filling of the cavity with demineralized bone matrix (DBX; Synthes [USA], Paoli, PA). We believe that endoscopically assisted curettage presents several advantages over open curettage alone. First, direct visualization of the medullary canal permits accurate assessment of the extent of the enchondroma. Second, the endoscope permits accurate assessment of the adequacy of the curettage, thus avoiding the need to perform multiple, blind, and aggressive passes with a curette. Multiple passes can increase the risk of violation of the cortical shell and can prolong the procedure. Third, the ability to completely clear the medullary canal of all tumors should logically reduce the rate of recurrence. In conclusion, the addition of an endoscope is an inexpensive modification that promises to save time, decrease morbidity, and possibly improve long-term outcomes.

Published 11 June 2007 in Arthroscopy, 23(6): 678.e1-4.
Full-text of this article is available online (may require subscription).

© 2004-2008 Bone Cancer Research Today. All Rights Reserved.