Backgrond
Over the past few years, there has been much interest in the study of tumors and tumorlike conditions around the hand and the wrist. Most of the tumorous conditions result from repetitive strain injuries, but other true tumors do exist.
Objective
The aim of the work was to clarify the nature, incidence, and distribution of soft tissue tumors and tumorous conditions around the wrist and the hand. This study should clarify the correlation between false and true tumors of the hand and also between benign and malignant tumors.
Patients and methods
This study includes 178 patients with hand and wrist soft tissue swellings of 107 005 patients who received medical care at Orthopaedic Department at El-Hadara University Hospital during 1 year (from November 2006 to the end of October 2007). Thus, patients of this study represent 0.30% of the patients admitted from the outpatient clinic.
Results
The present study included 178 patients with soft tissue tumors or tumorlike conditions of the hand and wrist. The most common type was tenosynovitis (48%), and the second common type was simple ganglion (41%). The remaining types were Dupuytren’s contracture (4%), giant cell tumor of tendon sheath (4%), chronic synovitis (0.6%), fibroma (0.6%), neuroma (0.6%), dermoid cyst (0.6%), and synovial sarcoma (0.6%). Malignancy constitutes only 0.6% of the present study. The most commonly affected patients were those in the age between 30 and 49 years; however, the age ranged between 10 and 67 years. Overall, 108 (60.6%) patients were females, whereas the remaining 70 (39.4%) were males. Regarding the occupation, housewives (62 patients; 34.8%) were more commonly affected than those in other occupation. The main presentations were interference with function (75 patients; 42%) and unsightly swelling (62 patients; 36%).
Conclusion
Malignancy constitutes only 0.6% of the present study. History of diabetes was evident in 56 (31.5%) patients. The incidence of recurrence was very high in cases of trigger finger managed by injection of corticosteroid, ganglia in which injection was done as outpatient procedure, or also where transfixation was done or even after excision. Synovial sarcoma did not show recurrence or metastasis. Regarding the site of the lesion, the palmar aspect of the right hand was affected more than the left side. The smallest size of the swellings measured 0.5 cm (ganglion on the dorsum of proximal interphalangeal joint), whereas the largest one measured 4 by 7 cm (chronic synovitis).