Enchondromas of the hand in children: current concepts in etiopathogenesis, diagnosis, and treatment: a review

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Abstract

The prevalence of benign bone tumors among pediatric patients highlights the relevance of such investigations for orthopedic practice. This article focuses on hand enchondromas in children. Despite the relative frequency of this condition, the lack of clinical guidelines for this disease area underscores the relevance of the publication. A total of 69 full-text articles were selected from 387 sources identified through searches in CyberLeninka, eLibrary, PubMed, and Scopus from 1990 to 2023. This review presents current views on the etiopathogenesis, diagnostic and therapeutic challenges, and prognosis of hand enchondromas in children. Radiography and computed tomography are the primary diagnostic methods for hand enchondromas. Histological verification of diagnosis is mandatory. Particular attention should be given to surgical treatment strategies, including the optimal timing and extent of intervention, selection of grafting material, risk factors, and frequency of recurrence. The scientific data analysis enabled the systematization of data on the etiopathogenesis of hand enchondromas, identification of diagnostic priorities, clarification of diagnostic and differential diagnostic criteria, and refinement of approaches to treatment strategy and methods. The choice of treatment strategy, including the method and timing of intervention, should be individualized, taking into account tumor localization and histogenesis, as well as any additional diagnostic findings and the risk of complications. In recent years, specialists have tended to favor early surgical intervention over wait-and-see approaches, with the choice between autograft and allograft being determined by the clinical context. Autografts are considered the gold standard; however, the use of allografts for restoring the structural and functional integrity of bone in cases of injury is a reasonable and well-substantiated alternative, even in the light of the high risks of donor site morbidity. Such decisions should be made collaboratively, considering the opinions of the involved specialists, including orthopedic oncologists, radiologists, pathologists, and rehabilitation physicians.

About the authors

Lilia A. Cherdantseva

Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: cherdanceff@yandex.ru
ORCID iD: 0000-0002-4729-3694
SPIN-code: 9409-0400

MD, PhD, Cand. Sci. (Medicine)

Russian Federation, 17 Frunze st., Novosibirsk, 630091

Maria V. Duginova

Multidisciplinary Medical Center “Euromed”

Email: duginova.m@mail.ru
ORCID iD: 0000-0002-2352-3539
SPIN-code: 2615-4122

MD

Russian Federation, Novosibirsk

Elena V. Gubina

Center for New Medical Technologies in Koltsovo

Email: Egubina@niito.ru
ORCID iD: 0000-0002-2278-1421
SPIN-code: 2847-4563

MD, PhD, Cand. Sci. (Medicine)

Russian Federation, Novosibirsk

Irina A. Kirilova

Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics

Email: irinakirilova71@mail.ru
ORCID iD: 0000-0003-1911-9741
SPIN-code: 9482-9230

MD, PhD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Novosibirsk

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2. Fig. 1. Hasselgren classification of hand enchondromas. I: tumor type, namely, monostotic (A), polyostotic (B), and giant (C); II: tumor shape, namely, non-expansile (A) and expansile/spreading (B); III: tumor localization, namely, central (A), eccentric (B), and associated (C). © Orman O. et al., 2022. Licensed under CC BY-NC 4.0. Source: adapted from [DOI: 10.14744/SEMB.2022.00483].

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3. Fig. 2. Enchondroma. Lobules of hyaline cartilage with a thin fibrous tissue capsule surrounding the lobules. Hematoxylin and eosin staining, magnification ×50. © Academy of Medical Sciences, Romanian Academy Publishing House, Bucharest, 2022. Licensed under CC BY-NC 4.0. Source: adapted from [DOI: 10.47162/RJME.63.4.04].

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4. Fig. 3. A 17-year-old patient with displaced pathological fracture of the proximal phalanx. © Çapkin S. et al., 2020. Licensed under CC BY-NC 4.0. Source: adapted from [DOI: 10.7759/cureus.7497].

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