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Allograft Impaction and Supplementary Plating for the Management of Epi-Metaphyseal Enchondroma: A Rare Case Report

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Introduction: Enchondroma is a common bone tumor; however, its location in the proximal epi-metaphyseal region of the tibia is a rare finding. Its management is complicated by the weight-bearing nature of the site and despite an array of available treatment modalities in the literature, there is no fixed consensus. Case Report: Through this case, we report a 60-year-old female who was evaluated for bilateral knee osteoarthritis. On plain radiography, a lytic lesion was noted which on CT guided biopsy was confirmed to be an enchondroma of the right proximal tibia. The patient underwent extensive curettage, allograft impaction, and supplementary fixation by a poly ethyl ether ketone plate. Following a period of immobilization, she was able to walk full weight-bearing after 3 weeks of the surgery and carry out her daily activities at 2 months. At 1 year postoperatively, the patient achieved excellent clinical, radiological, and functional outcomes without any complications. Conclusion: Management of an enchondroma in weight-bearing regions of long bones can pose multiple challenges. Timely diagnosis and management by thorough curettage, uncompromised allograft impaction, and supplementary fixation by a PEEK plate give excellent short-term and long-term results.
Title: Allograft Impaction and Supplementary Plating for the Management of Epi-Metaphyseal Enchondroma: A Rare Case Report
Description:
Introduction: Enchondroma is a common bone tumor; however, its location in the proximal epi-metaphyseal region of the tibia is a rare finding.
Its management is complicated by the weight-bearing nature of the site and despite an array of available treatment modalities in the literature, there is no fixed consensus.
Case Report: Through this case, we report a 60-year-old female who was evaluated for bilateral knee osteoarthritis.
On plain radiography, a lytic lesion was noted which on CT guided biopsy was confirmed to be an enchondroma of the right proximal tibia.
The patient underwent extensive curettage, allograft impaction, and supplementary fixation by a poly ethyl ether ketone plate.
Following a period of immobilization, she was able to walk full weight-bearing after 3 weeks of the surgery and carry out her daily activities at 2 months.
At 1 year postoperatively, the patient achieved excellent clinical, radiological, and functional outcomes without any complications.
Conclusion: Management of an enchondroma in weight-bearing regions of long bones can pose multiple challenges.
Timely diagnosis and management by thorough curettage, uncompromised allograft impaction, and supplementary fixation by a PEEK plate give excellent short-term and long-term results.

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