수부에 발생한 골연골증

Abstract

Osteochondroma in the hand is rare lesion. This study was conducted to recognize the clinical patterns of this rare disease entity and to evaluate the diagnosing modalities and prognosis along with its differential diagnoses. We reported 8 cases of osteochondroma in the hand. Analysis on sex, age, site of the lesion, growth pattern, diagnostic methods, and pathologic findings were made. The patients included 4 males and 4 females with an average age 24 years(range, 4 months to 50 years). Three lesion presented clinically with tenderness ; the others presented as masses of swelling. There was tenderness in 3 cases, limitation of extension in 2 cases and limitation of flexion in 2 cases. The size of the osteochondroma was below 1.0 cm3 and only two cases measured over 2.0 cm in length. The four cases occurred in the second finger and 2 cases in the fifth finger and others in the thumb and long finger. The cancellous connection was found in 7 cases which were grown on the metaphyseal area. Extra-skeletal osteochondroma at the finger tip was observed in the remaing case. The five cases were found in the proximal phalanx, 2 cases in the metacarpal bone. The osteochondroma in the distal phalanx was not observed except extraskeletal case. There were 1 case which is multiple osteochondroma. The dominant sites of the osteochondroma in hand were the metaphysis, proximal phalanx and index finger. The preservation of the cartilage cap and cancellous portion is important during operation for the accurate pathologic diagnosis. Through accurate evaluation, prevention of misdiagnosis is mandatory. So, marginal excision preserving cartilage is important.