PMC7412894_01
The X-ray (a) shows a well-defined lytic and expansile lesion measuring 15 mm x 7 mm of the left fourth proximal phalanx. The MRI (b) shows a moderate to hyperintensive lesion at the same location.
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X-rays exhibited a lucent lesion within the proximal phalanx measuring 15 mm x 7 mm (Figure 1(a)). Magnetic resonance imaging (MRI) (Figure 1(b)) showed an expansile lesion breaching the inferior and lateral cortical bone.
The enchondroma before (a) and following (b) resection.
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The enchondroma was resected using a sagittal saw and rongeur forceps via a dorsal-linear incision (Figure 2(a) and (b)) and sent for histological examination.
An autologous bone graft harvested from the distal tibia before (a), during (b), and after (c) resection.
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At the level of the tibia, a lineal incision was used (Figure 3(a)) and a cortical and cancellous bone graft was harvested from the distal metaphysis (Figure 3(b)). This was cut to size using a sagittal saw (Figure 3(c)) and inserted into the osseous gap left from the resection (Figure 4(a)).
The inserted autologous bone graft before (a) and after (b) closure.
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This was cut to size using a sagittal saw (Figure 3(c)) and inserted into the osseous gap left from the resection (Figure 4(a)). Both wounds underwent layered closure using 2-0 and 3-0 Vicryl (polyglactin 910) and 3-0 Monocryl (poliglecaprone 25) sutures (Figure 4(b)).
Postoperative anterior-posterior (a), medial oblique (b), and lateral (c) X-rays showing fixation of the graft with 1.6 mm percutaneous Kirschner wire.
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Enchondroma micrograph. The 15 mm x 10 mm x 10 mm cylindrical fragment was submitted for decalcification before processing and then processed as four transverse slices in two blocks. The section exhibited a well-circumscribed tumour composed of lobules of hyaline cartilage encased by bone and covered by fibrous tissue. There was no significant multi-nucleation, atypia, or mitotic activity. Focal haemorrhage and reactive vascularisation was seen within the lesion. No evidence of malignancy was identified.
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Histology showed a well-circumscribed tumour composed of lobules of hyaline cartilage encased in bone and covered by fibrous tissue (Figure 6).