Digit-sparing surgery for hand bone tumors: results of en-bloc bone resection and repla cement with osteoarticular allografts.
Year: 2025
Type: article
Study design: Case Report
Abstract: Introduction: The treatment of malignant bone tumors in the hand should be focused on the complete removal of the neoplasm. Thereby, amputation of the involved digital ray or even the whole hand is often necessary. However, a ray-sparing approach could be sufficient to eradicate locally aggressive and low-grade malignant tumors confined to the bone. Aim: We present our experience with en-bloc resection of long bones of the hand and their replacement with osteoarticular allografts. Materials and methods: We evaluated all our cases with locally aggressive low-grade bone tumors of the hand, treated with a whole-bone en-bloc resection and replaced with an osteoarticular allograft. Intraoperative and postoperative complications were recorded. Patients’ preoperative and postoperative functionality was assessed with the MSTS score and eventual post-operative digital ray stiffness was classified using the Tubiana classification. Results: Five patients were included in our study (1 metacarpal, 3 proximal, and 1 middle phalanx). Cases had grade 1 CS (3), GCT of the bone (1), or Gorham-Stout disease (GSD; 1). The mean FU was 19 months. The patient with GSD (middle phalanx) had a local recurrence and underwent ray amputation. The patient treated in his metacarpal bone had a slight finger rotation (about 5°), but no stiffness. The three cases treated with proximal phalanx allografts were Tubiana 1A (1) or 1B (2). The mean MSTS score was 26.4. Conclusions: A digit-sparing surgery, performed with a whole-bone en-bloc resection and the implant of an osteoarticular allograft, could represent a solution for selected cases with locally aggressive and low-grade malignant tumors of the long bones in the hand.
Source: PubMed
Authors: Lorenzo Andreani, Martina Cordoni, Elena Bechini, Fabrizia Gentili, Andrea De Blasi, Antonio D'Arienzo, Edoardo Ipponi, Paolo Domenico Parchi
Institution: University of Pisa
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4409781924