Published in:
01-06-2014 | Original Article
A management algorithm for the management of symptomatic solitary upper limb osteochodroma
Published in: European Orthopaedics and Traumatology | Issue 2/2014
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Background
Osteochondromas are the most common benign bone tumour accounting for 20–50 % of benign bone tumours. Upper limb osteochondroma may incidentally present during unrelated radiological investigation, with mass effect symptoms or fracture. A cartilaginous cap size of >1.5 cm is associated with malignant change. We present our experience with upper limb osteochondroma and describe a management algorithm.
Methods
All diagnoses of osteochondroma since the establishment of the unit were managed according to a standard treatment algorithm. Patients were recalled for review. Clinical, operative, radiological, and histological data were analysed. Surgical or non-surgical clinical pathway was reviewed and outcome measures were recorded and analysed with univariate and categorical tests.
Results
There were 16 patients, ten male, with a median age of 34.9 years. Seven presented incidentally. Thirteen were humeral and three were scapular. Six required surgical excision due to cartilaginous cap size >1.5 cm or mass-effect symptoms. There were no complications in the operative cohort. All patients reported no difference in shoulder range of movement and there was no difference in disabilities of the arm, shoulder and hand score at final follow-up (p = 0.19). Two patients died of unrelated causes and did not complete full assessment.
Conclusions
Upper limb osteochondroma can be safely managed using a standard treatment algorithm. Excisional biopsy of symptomatic osteochondroma is safe and does not negatively affect function of the upper limb.