TREATMENT OF BENIGN AND LOW-GRADE MALIGNANT INTRAMEDULLARY CHONDROID TUMORS WITH CURETTAGE AND CRYOSURGERY

Aims. To shed light on the controversy surrounding the methods of eval uating, staging and final treatment of intramedullary chondroid lesion s. Controversy particularly exists for enchondroma and low-grade chond rosarcoma located in the extremities, because their accurate distincti on is hampered by their radiographical and histological similarity. Me thods. Since 1991 we have treated 22 patients (mean age: 39.6 years) w ith 26 lesions (three chondroblastomas, 14 enchondromas and nine grade 1 chondrosarcomas) with curettage. cryosurgery and bone grafting. Res ults. After a mean follow-up of 26 months no recurrences were observed . Complications consisted of two postoperative fractures, one wound in fection and one intraoperative venous gas embolism. All bone grafts in corporated, resulting in full weight-bearing capacity and excellent fu nctional results. Conclusion. The usefulness of a combination of curet tage and cryosurgery as adjuvant therapy is considered to be equal to marginal resection according to orthopaedic oncological principles. Th e pre-operative assessment of these lesions and cryosurgical technique is described in detail.