Case report
Giant enchondroma of the thumb distal phalanx. Presentation of a case and review of the literature
Encondroma gigante falange distal del pulgar. A propósito de un caso y revisión de la bibliografía
Read
3410
Timeswas read the article
646
Total PDF
2764
Total HTML
Share statistics
array:24 [ "pii" => "S1988885612000235" "issn" => "19888856" "doi" => "10.1016/j.recote.2011.10.006" "estado" => "S300" "fechaPublicacion" => "2012-03-01" "aid" => "310" "copyright" => "SECOT" "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Rev Esp Cir Ortop Traumatol. 2012;56:160-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1394 "formatos" => array:2 [ "HTML" => 1123 "PDF" => 271 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1888441511003298" "issn" => "18884415" "doi" => "10.1016/j.recot.2011.10.008" "estado" => "S300" "fechaPublicacion" => "2012-03-01" "aid" => "310" "copyright" => "SECOT" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Rev Esp Cir Ortop Traumatol. 2012;56:160-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5232 "formatos" => array:3 [ "EPUB" => 14 "HTML" => 4627 "PDF" => 591 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Nota clínica</span>" "titulo" => "Encondroma gigante falange distal del pulgar. A propósito de un caso y revisión de la bibliografía" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "160" "paginaFinal" => "163" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Giant enchondroma of the thumb distal phalanx. Presentation of a case and review of the literature" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1678 "Ancho" => 902 "Tamanyo" => 240198 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Técnica quirúrgica reconstructiva. A) Curetaje cavidad tumoral. B) Relleno cavitario con chips esponjosos e injerto corticoesponjoso estructural. Estabilización con aguja de Kirschner axial.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Gómez Fernández, J.M. Méndez López, J.G. Moranta Mesquida" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Gómez Fernández" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Méndez López" ] 2 => array:2 [ "nombre" => "J.G." "apellidos" => "Moranta Mesquida" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1988885612000235" "doi" => "10.1016/j.recote.2011.10.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885612000235?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441511003298?idApp=UINPBA00004N" "url" => "/18884415/0000005600000002/v1_201305031857/S1888441511003298/v1_201305031857/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1988885612000314" "issn" => "19888856" "doi" => "10.1016/j.recote.2012.03.005" "estado" => "S300" "fechaPublicacion" => "2012-03-01" "aid" => "317" "copyright" => "SECOT" "documento" => "article" "crossmark" => 0 "subdocumento" => "ssu" "cita" => "Rev Esp Cir Ortop Traumatol. 2012;56:164-73" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1518 "formatos" => array:2 [ "HTML" => 1259 "PDF" => 259 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>" "titulo" => "Aspects of interest on vitamin D for the traumatologist and orthopaedic surgeon" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "164" "paginaFinal" => "173" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aspectos de interés para el cirujano ortopédico y traumatólogo sobre la vitamina D" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2184 "Ancho" => 2952 "Tamanyo" => 385511 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Endocrine and autocrine actions of vitamin D.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Mesa-Ramos, J.R. Caeiro-Rey, I. Etxebarría-Foronda, P. Carpintero-Benítez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Mesa-Ramos" ] 1 => array:2 [ "nombre" => "J.R." "apellidos" => "Caeiro-Rey" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Etxebarría-Foronda" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Carpintero-Benítez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441511003535" "doi" => "10.1016/j.recot.2011.11.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441511003535?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885612000314?idApp=UINPBA00004N" "url" => "/19888856/0000005600000002/v1_201305031803/S1988885612000314/v1_201305031803/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1988885612000223" "issn" => "19888856" "doi" => "10.1016/j.recote.2011.10.005" "estado" => "S300" "fechaPublicacion" => "2012-03-01" "aid" => "306" "copyright" => "SECOT" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Rev Esp Cir Ortop Traumatol. 2012;56:156-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1555 "formatos" => array:2 [ "HTML" => 1221 "PDF" => 334 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Unilateral congenital absence of the carpal scaphoid associated with dysplasia of the capitate. Presentation of a case" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "156" "paginaFinal" => "159" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ausencia congénita unilateral del escafoides carpiano y displasia del hueso grande. A propósito de un caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2329 "Ancho" => 901 "Tamanyo" => 392580 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nuclear magnetic resonance study.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Gómez Fernández, J.M. Méndez López, F. Caracuel Redondo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Gómez Fernández" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Méndez López" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Caracuel Redondo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S188844151100292X" "doi" => "10.1016/j.recot.2011.10.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S188844151100292X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885612000223?idApp=UINPBA00004N" "url" => "/19888856/0000005600000002/v1_201305031803/S1988885612000223/v1_201305031803/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Giant enchondroma of the thumb distal phalanx. Presentation of a case and review of the literature" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "160" "paginaFinal" => "163" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.M. Gómez Fernández, J.M. Méndez López, J.G. Moranta Mesquida" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J.M." "apellidos" => "Gómez Fernández" "email" => array:2 [ 0 => "jgomezf@mc-mutual.com" 1 => "mgofecot@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J.M." "apellidos" => "Méndez López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.G." "apellidos" => "Moranta Mesquida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de la Mano y Nervio Periférico, Servicio de Cirugía Ortopédica y Traumatología, MC-Mutual, Hospital Sagrat Cor, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Rehabilitación, MC-Mutual, Hospital Sagrat Cor, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Encondroma gigante falange distal del pulgar. A propósito de un caso y revisión de la bibliografía" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1011 "Ancho" => 512 "Tamanyo" => 83904 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Clinical aspect of the thumb. (B) Radiological image of the tumorous lesion.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Enchondroma is the most common benign, primary tumour of the hand,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> especially in the phalanges and metacarpals, and more rarely in the carpal bones. They are generally single tumours (solitary enchondroma), but they occasionally simultaneously affect 2 phalanges or 1 phalanx and the metatarsal of the same digital area. The most frequent location is at the level of the proximal phalanx, followed by the middle phalanx and the metacarpals. The position in the distal phalanx is very rare and location in the thumb, exceptional.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The objective of this article is to present a new case of rapidly growing enchondroma of the distal phalanx of the thumb, with clinical and radiological characteristics aggravating its prognosis. We also present the surgical technique performed and tumour development, as well as a review of the literature.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Clinical case</span><p id="par0015" class="elsevierStylePara elsevierViewall">This was a 21-year-old woman, a monitor on transport adapted for the disabled, who came to the consultation due to pain and localised deforming swelling located in the left thumb, of a progressive nature. Clinical examination showed severe deformity of the distal end of the finger, of both the fleshy part and the nail, with global thickening, pain upon local finger palpation but with no limitations in interphalangeal joint function (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). The radiological examination revealed a central lytic image with small calcifications, occupying the entire distal phalanx, and which penetrated the cortical along its entire surface, thinning it, but without structural continuity (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The patient provided a gammagraphy, which evidenced intense hyper-uptake in F2 without affiliated swelling. Nuclear magnetic resonance (NMR) revealed an image compatible with giant cell tumour, making a differential diagnosis with enchondroma. An operation for excision and reconstruction was planned, without being able to eliminate the possibility of amputation given the severe bone deformity. The patient was operated on with regional anaesthesia (axillary block) and preventative ischaemia, preparing the contralateral iliac crest. Using a longitudinal, dorsal approach, after ungual removal, we performed curettage of the entire bone cavity, sending the content for anatomopathological study. Next, given the cortical weakness after the curettage, we reconstructed the distal phalanx of the thumb using a structural cortico-cancellous graft and cancellous chips. The assembly was stabilised with a Kirschner wire as a guide (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B). The biopsy confirmed that the tumour was an enchondroma without atypical cells. At 4 weeks, the Kirschner wire was removed and rehabilitation was initiated. We performed clinical and radiological controls periodically, with the last one at 8 months after the surgery. At that time, the patient was asymptomatic, with complete flexion-extension function of the distal phalanx, and the radiological study showed progressive resolution of the tumorous lesion with clear bone remodelling (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A–C).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Enchondroma is the most common primary tumour of the tubular bones of the hand, developing between the first and fourth decade.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In the majority of the cases (75%), they are monostotic or singular (solitary enchondroma).</p><p id="par0025" class="elsevierStylePara elsevierViewall">Their most common position is at the level of the proximal phalanx, followed by the middle and the metacarpals, and they are found more rarely in the carpal bones. At the level of the distal phalanx, such tumours are extremely infrequent, representing 11.4% of the cases,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and if we speak of affecting the thumb, they are exceptional (1% of total hand enchondroma).</p><p id="par0030" class="elsevierStylePara elsevierViewall">They present no specific clinical signs and symptoms in the initial stages, and very slight ones in advanced stages. Many cases are discovered in radiological examinations performed for other reasons. In other cases, the patient seeks a consultation after suffering a trauma and the pathological fracture is diagnosed after radiological study. On some occasions, the fracture is accompanied by a bone avulsion of the deep flexor tendon insertion, so active flexion of the distal phalanx is limited, apart from having pain.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–9</span></a> In this case, the strongest clinical manifestation was the progressive, deforming swelling of the distal end of the finger, along with pain, without any prior traumatic antecedents.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The radiological image of the enchondroma is characteristic: a well-defined radiolucent or lytic lesion with small calcifications, the bone appearing penetrated and with the cortical thinned in cases of prolonged development, with a minimal sclerotic halo around it. Takigawa<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> classified the enchondroma according to their position and extension, from the central enchondroma to the eccentric, with cases of very extensive affectation and others of a polycentric nature. Our case is considered gigantic (occupying the entire distal phalanx).</p><p id="par0040" class="elsevierStylePara elsevierViewall">Performing complementary studies, such as bone gammagraphy, computerized axial tomography or NMR, can help to confirm the diagnosis, tumour demarcation and its extension. In our case, the NMR led to the differential diagnosis with giant-cell tumour.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Enchondroma treatment must be considered individually in each case. In initial cases of small extension, a simple curettage with a teaspoon through a cortical window is normally sufficient.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10</span></a> In intermediate cases of greater extension, the defect created after tumour curettage should be filled with a bone graft<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> extracted from the iliac crest or from the distal end. Exceptionally, in the case of an associated pathological fracture with or without tendon avulsion, fixation with Kirschner wires or a miniplate with screws is needed. However, it must not be forgotten that when an enchondroma in the hand is fractured, its initial treatment should be conservative, because such a fracture makes the enchondroma become ossified; once the fracture consolidates, curettage and graft filling of the remaining enchondroma can be performed to prevent refracture. In the last few years, bone substitutes are being used more and more often to fill the bone defect created. They are very expensive but they simplify the surgery and make it possible to use regional anaesthesia, avoiding hospital admission.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> In our literature review, we have seen that Wulle<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> utilised plaster in 3 cases. Yamamoto et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and Bauer et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> use hydroxyapatite and Yasuda et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> injects calcium phosphate cement into the bone defect. In cases of massive affectation of the phalanx or metatarsal, Bikels et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> complements tumour curettage by placing 1 or 2 Kirschner wires inside the centre, filling the cavity with bone cement (PMMA). Finally, the approach used will always be conditioned by the size of the lesion and its position. Either the lateral or palmar approach can be used.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> However, in our case, given the ungual deformity involved and the greater dorsal affectation, we chose a dorsal approach facilitated by the ungual excision.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Level of evidence</span><p id="par0050" class="elsevierStylePara elsevierViewall">Level IV evidence.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical Disclosures</span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Protection of human and animal subjects</span>. The authors declare that no experiments were performed on humans or animals for this investigation.</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Confidentiality of Data</span>. The authors will declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study.</p><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Right to privacy and informed consent</span>. The authors must have obtained the informed consent of the patients and /or subjects mentioned in the article. The author for correspondence must be in possession of this document.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres116448" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec103733" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres116447" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec103734" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Level of evidence" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Ethical Disclosures" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-09-25" "fechaAceptado" => "2011-10-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec103733" "palabras" => array:3 [ 0 => "Enchondroma" 1 => "Bone tumour hand" 2 => "Distal phalanx" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec103734" "palabras" => array:3 [ 0 => "Encondroma" 1 => "Tumor óseo de la mano" 2 => "Falange distal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">We report on a case of giant enchondroma of the distal phalanx of the thumb, with a significant degree of clinical and radiographic deformity. It is extremely rare in this location and its treatment should be surgical, with curettage of the lesional cavity and filling with autologous bone graft. In this case, we performed a differential diagnosis of a giant cell tumour and aneurysmatic bone cyst (X-ray and nuclear magnetic resonance [NMR]).</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos un caso de encondroma gigante de la falange distal del pulgar, con importante deformidad clínica y radiológica, extremadamente infrecuente en dicha localización y cuyo tratamiento es quirúrgico mediante curetaje de la cavidad lesional y relleno con autoinjerto óseo. En este caso realizamos diagnóstico diferencial con tumor de células gigantes y quiste óseo aneurismático (radiológico y resonancia magnética nuclear).</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Gómez Fernández JM, et al. Encondroma gigante falange distal del pulgar. A propósito de un caso y revisión de la bibliografía. Rev Esp Cir Ortop Traumatol. 2012;<span class="elsevierStyleBold">56(2)</span>:160-163.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1011 "Ancho" => 512 "Tamanyo" => 83904 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Clinical aspect of the thumb. (B) Radiological image of the tumorous lesion.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1004 "Ancho" => 542 "Tamanyo" => 144629 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Surgical reconstructive technique. (A) Tumour cavity curettage. (B) Cavity filling with cancellous chips and a structural cortico-cancellous graft. Stabilisation with an axial Kirschner wire.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1026 "Ancho" => 1265 "Tamanyo" => 161051 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Radiological image at 8 months. (B) and (C) Clinical aspect at 8 months.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary bone tumours of the hand and wrist" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.A. Campbell" 1 => "P.A. Millner" 2 => "C.R. Dreghorn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1995" "volumen" => "20B" "paginaInicial" => "5" "paginaFinal" => "7" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enchondroma of the distal phalanx of the hand" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Shimizu" 1 => "Y. Kotoura" 2 => "N. Nishijima" 3 => "T. Nakamura" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "1997" "volumen" => "79A" "paginaInicial" => "898" "paginaFinal" => "900" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chondroma of the bones of the hand. A review of 110 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. Takigawa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "1971" "volumen" => "53" "paginaInicial" => "1591" "paginaFinal" => "1600" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5121800" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Avulsion of flexor profundus, secondary to enchondroma of the distal phalanx" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O. Ogunro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1983" "volumen" => "8" "paginaInicial" => "315" "paginaFinal" => "316" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flexor digitorum profundus avulsion through enchondroma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Froimson" 1 => "L. Shall" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1984" "volumen" => "9B" "paginaInicial" => "343" "paginaFinal" => "344" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rupture of the tendon of flexor digitorum profundus in association with an enchondroma of the terminal phalanx" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Vaz" 1 => "H. Belcher" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1998" "volumen" => "23B" "paginaInicial" => "548" "paginaFinal" => "549" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Avulsion of the flexor digitorum profundus tendon associated with a condroma of the distal phalanx" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Canovas" 1 => "F. Nicolau" 2 => "F. Bonnel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1998" "volumen" => "23A" "paginaInicial" => "130" "paginaFinal" => "131" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flexor digitorum profundus tendon avulsion through a recurrent enchondroma. A case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.B. Chen" 1 => "D.C. Yee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hand Surg" "fecha" => "2001" "volumen" => "6" "paginaInicial" => "125" "paginaFinal" => "126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11677676" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arrancamiento del flexor profundo a través de un encondroma: a propósito de un caso y revisión de la bibliografía" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.M. Méndez López" 1 => "X. Martín Oliva" 2 => "J.M. Gómez Fernández" 3 => "R. Chiavegatti" 4 => "M. Armadás" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cir Ortop Traumatol" "fecha" => "2011" "volumen" => "55" "paginaInicial" => "389" "paginaFinal" => "391" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The treatment of enchondromas in the hand by endoscopic curettage whitout bone grafting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Sekiya" 1 => "N. Matsui" 2 => "T. Osutka" 3 => "M. Kobayashi" 4 => "D. Tsuchiya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1997" "volumen" => "22B" "paginaInicial" => "230" "paginaFinal" => "234" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is the treatment of enchondroma in the hand by simple curettage a rewarding method?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Tordai" 1 => "M. Hoglund" 2 => "H. Lugnegard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1990" "volumen" => "15B" "paginaInicial" => "331" "paginaFinal" => "334" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of enchondromas of the hand with bone Substitutes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Jacoulet" 1 => "P. Faure" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1997" "volumen" => "22 B" "paginaInicial" => "476" "paginaFinal" => "478" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "On the treatment of enchondroma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Wulle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "1990" "volumen" => "15B" "paginaInicial" => "320" "paginaFinal" => "330" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of hydroxyapatite to fill cavities alter escisión of benign bone tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Yamamoto" 1 => "T. Onga" 2 => "T. Marui" 3 => "K. Mizuno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "2000" "volumen" => "82B" "paginaInicial" => "1117" "paginaFinal" => "1120" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spongy hydroxyapatite in hand surgery. A five year follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W. Bauer" 1 => "P. Schaller" 2 => "H. Carl" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "2002" "volumen" => "27B" "paginaInicial" => "101" "paginaFinal" => "103" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of enchondroma of the hand with injectable calcium phosphate bone cement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Yasuda" 1 => "K. Masada" 2 => "E. Takeuchi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "2006" "volumen" => "31A" "paginaInicial" => "98" "paginaFinal" => "102" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enchondromas of the hand: treatment with curettage and cemented internal fixation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Bikels" 1 => "J.C. Wittig" 2 => "Y. Kollender" 3 => "K. Kellar-Graney" 4 => "K. Mansour" 5 => "I. Meller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "2002" "volumen" => "27B" "paginaInicial" => "870" "paginaFinal" => "875" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Encondroma de la falange distal del pulgar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Proubasta Renart" 1 => "I. Gracia Alegría" 2 => "A. Peiró Ibáñez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Avances Traum" "fecha" => "2008" "volumen" => "38" "paginaInicial" => "195" "paginaFinal" => "197" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000005600000002/v1_201305031803/S1988885612000235/v1_201305031803/en/main.assets" "Apartado" => array:4 [ "identificador" => "7586" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000005600000002/v1_201305031803/S1988885612000235/v1_201305031803/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885612000235?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 0 | 4 |
| 2024 October | 43 | 1 | 44 |
| 2024 September | 45 | 2 | 47 |
| 2024 August | 33 | 4 | 37 |
| 2024 July | 27 | 6 | 33 |
| 2024 June | 23 | 3 | 26 |
| 2024 May | 14 | 5 | 19 |
| 2024 April | 17 | 2 | 19 |
| 2024 March | 32 | 2 | 34 |
| 2024 February | 25 | 4 | 29 |
| 2024 January | 41 | 4 | 45 |
| 2023 December | 38 | 13 | 51 |
| 2023 November | 34 | 6 | 40 |
| 2023 October | 56 | 15 | 71 |
| 2023 September | 22 | 2 | 24 |
| 2023 August | 27 | 1 | 28 |
| 2023 July | 39 | 10 | 49 |
| 2023 June | 45 | 1 | 46 |
| 2023 May | 98 | 7 | 105 |
| 2023 April | 64 | 3 | 67 |
| 2023 March | 49 | 1 | 50 |
| 2023 February | 57 | 3 | 60 |
| 2023 January | 56 | 7 | 63 |
| 2022 December | 61 | 6 | 67 |
| 2022 November | 51 | 9 | 60 |
| 2022 October | 37 | 13 | 50 |
| 2022 September | 49 | 9 | 58 |
| 2022 August | 43 | 7 | 50 |
| 2022 July | 35 | 6 | 41 |
| 2022 June | 38 | 8 | 46 |
| 2022 May | 41 | 9 | 50 |
| 2022 April | 34 | 8 | 42 |
| 2022 March | 44 | 10 | 54 |
| 2022 February | 32 | 9 | 41 |
| 2022 January | 49 | 7 | 56 |
| 2021 December | 59 | 11 | 70 |
| 2021 November | 39 | 9 | 48 |
| 2021 October | 48 | 14 | 62 |
| 2021 September | 13 | 9 | 22 |
| 2021 August | 4 | 5 | 9 |
| 2021 July | 14 | 10 | 24 |
| 2021 June | 7 | 8 | 15 |
| 2021 May | 12 | 10 | 22 |
| 2021 April | 18 | 32 | 50 |
| 2021 March | 16 | 31 | 47 |
| 2021 February | 3 | 19 | 22 |
| 2021 January | 5 | 14 | 19 |
| 2018 February | 7 | 0 | 7 |
| 2018 January | 16 | 3 | 19 |
| 2017 December | 11 | 0 | 11 |
| 2017 November | 23 | 1 | 24 |
| 2017 October | 15 | 1 | 16 |
| 2017 September | 15 | 2 | 17 |
| 2017 August | 23 | 20 | 43 |
| 2017 July | 15 | 3 | 18 |
| 2017 June | 30 | 4 | 34 |
| 2017 May | 33 | 1 | 34 |
| 2017 April | 19 | 1 | 20 |
| 2017 March | 13 | 58 | 71 |
| 2017 February | 12 | 1 | 13 |
| 2017 January | 21 | 0 | 21 |
| 2016 December | 15 | 4 | 19 |
| 2016 November | 22 | 1 | 23 |
| 2016 October | 26 | 6 | 32 |
| 2016 September | 48 | 2 | 50 |
| 2016 August | 27 | 2 | 29 |
| 2016 July | 24 | 3 | 27 |
| 2016 June | 25 | 1 | 26 |
| 2016 May | 24 | 20 | 44 |
| 2016 April | 26 | 3 | 29 |
| 2016 March | 31 | 2 | 33 |
| 2016 February | 26 | 9 | 35 |
| 2016 January | 33 | 8 | 41 |
| 2015 December | 19 | 4 | 23 |
| 2015 November | 15 | 4 | 19 |
| 2015 October | 28 | 8 | 36 |
| 2015 September | 26 | 3 | 29 |
| 2015 August | 45 | 12 | 57 |
| 2015 July | 45 | 5 | 50 |
| 2015 June | 26 | 17 | 43 |
| 2015 May | 27 | 6 | 33 |
| 2015 April | 51 | 14 | 65 |
| 2015 March | 29 | 4 | 33 |
| 2015 February | 27 | 4 | 31 |
| 2015 January | 16 | 2 | 18 |
| 2014 December | 27 | 10 | 37 |
| 2014 November | 19 | 0 | 19 |
| 2014 October | 18 | 3 | 21 |
| 2014 September | 15 | 6 | 21 |
| 2014 August | 16 | 0 | 16 |
| 2014 July | 16 | 0 | 16 |
| 2014 June | 11 | 2 | 13 |
| 2014 May | 22 | 1 | 23 |
| 2014 April | 14 | 8 | 22 |
| 2014 March | 12 | 2 | 14 |
| 2013 July | 7 | 0 | 7 |
| 2013 June | 10 | 0 | 10 |
| 2013 May | 2 | 0 | 2 |
Show all
