Publication:

Advanced enchondroma of the phalanx treated by en bloc excision and tricortical iliac crest autograft

Curettage with or without augmentation forms the mainstay of treatment in most cases of enchondroma of the hand. Studies have shown that the chances of re-fracture increase with the increase in the bony involvement by the tumor and recommend augmentation for the larger lesions. Structural grafts are seldom used in enchondromas. There is only one reported case of the use of structural allograft in a case of recurrent enchondroma of the metacarpal. We present a case of advanced enchondroma involving the entire proximal phalanx which was managed by enblock excision with intercalary tricortical iliac crest strut grafting. Use of structural allograft in a case of enchondroma helps in augmenting the bony framework, providing stability and thus decreasing the chance of re-fracture at the site of lesion. The use of a tri-cortical graft provides better outcomes due to its osteoinductive and osteoconductive properties.