Management of hand chondromas : An analysis through a cases series enlightened by literature data

Purpose : Chondroma of the hand is a benign bone tumor characterized by proliferation of mature hyaline cartilage without histological evidence of chondrosarcoma. The diagnosis is suspected clinically and, in most cases, made by standard radiography, but histological analysis is essential to confirm it. The main problem with this pathology is the difficulty of making a differential diagnosis between a chondroma and a low-grade chondrosarcoma. Methods : We retrospectively analyzed medical records of chondromas of the hand for patients managed in our department during the period from March 2016 to March 2023 in order to identify epidemiological notions, and to establish a reconciliation between the clinical, radiological, anatomopathological and therapeutic aspects of chondromas of the hand while comparing with data in the literature. Results : The diagnosis was suspected on standard radiography, which revealed a medio-diaphyseal osteolytic lesion with clear and regular borders, lobulated in the majority of cases, with an average size of 13 mm, no cortical involvement or periosteal reaction were detected. “Pop-corn” calcareous deposits were present in 50% of our patients. The only form found in our study was solitary chondroma. The use of additional imaging (CT, MRI, scintigraphy) was not necessary, since the typical radiological presentation of chondroma and the concordance with clinical findings. Therapeutic management of our patients was surgical, with the tumor resected in its entirety after medial lateral incision in all our patients, followed by bone filling in 8 patients (Group A) and without filling in 4 patients (Group B). We confirmed the diagnosis by anatomopathological study after tumor resection. The outcome was favorable in 66.6% of our patients, and 33.3% presented joint stiffness, of which 25% suffered from this symptomatology preoperatively. Conclusion : Surgical excision is the standard treatment for symptomatic lesions. However, controversy surrounds the value of post-curettage void filling and the timing of surgery for pathological fractures, as well as the use of surgical adjuvants.