PRACTICE OF SURGICAL TREATMENT OF ENCHONDROMAS OF HAND BONES WITH APPLICATION OF COLLAPAN (HYDROXYAPATITE-COLLAGEN) BIOMATERIAL
Since January 2007 till July 2016, 104 patients (76 women and 28 men) with enchondromas of finger bones and metacarpal bones were treated in the department of hand injuries. In 66 patients, the defect was filled with CollapAn (hydroxyapatite-collagen) biomaterial with different antibiotics. 38 patients received the bone grafting of the defect by spongy auto graft from the metaphyseal zone of the radial or tibial bone. Plasty of the cortical window by three different methods in the both groups was made in 84 patients. Remote results were assessed retrospectively in 18 of 38 patients after bone autografting in the terms from 1 to 6 years and observed prospectively in 54 of 66 patients after plastic by CollapAn biomaterials in the terms from 4 months to 3.5 years. In the group with CollapAn, the radiologic result of the surgery was qualified as Tordai 0 in 35 cases (65%), Tordai I in 15 cases (28%), Tordai II in 4 cases (7%), recurrent enchondroma was not observed. In the group with spongy auto graft, the radiological result of treatment was qualified as Tordai 0 in 11 cases, Tordai I in 4 cases, Tordai II in 2 cases, and 1 patient had recurrent enchondroma - Tordai III. The result of treatment in general by the modified Wilhelm-Feldmeier formula in the group with CollapAn was assessed as excellent in 38 patients, good in 13 patients, satisfactory in 3 patients; no unsatisfactory results were observed. In the group with auto grafts, the result was assessed as excellent in 14 patients, good in 3 patients, no satisfactory results were observed, unsatisfactory result (recurrent enchondroma) took place in 1 patient. The data of the study have shown that the use of the CollapAN biomaterial is a good alternative to autografting of the bone cavity after removal of enchondroma of hand bones for reasons of simplicity and exclusion of morbidity of the donor zone.