Fractures of Osteochondroma during Physical Exercise

Abstract

BACKGROUND: The mechanism responsible and the best form of treatment for fractures of osteochondromas remain unclear. PURPOSE: We studied the incidence, cause, treatment, and outcome of fractures of osteochondroma over a 17-year period. STUDY DESIGN: Retrospective cohort study. METHODS: We retrospectively reviewed all cases of osteochondroma at one institution over 17 years (1985 to 2002) to identify cases of fractures. These patients were then contacted for follow-up. RESULTS: Seven cases of fracture through the stalk of a pedunculated osteochondroma were identified. All fractures were sustained during physical exercise. One fracture was due to a direct blow, and the others to indirect muscle or tendon injury. Five patients were treated surgically with excision of the osteochondroma, and the other two received nonoperative treatment consisting of restriction of physical activity and observation. In all cases, patients were able to resume sporting activity within 4 to 8 weeks. The recovery period was shorter for patients who received surgical treatment. CONCLUSIONS: Surgical excision of the fractured osteochondroma may be preferable for patients engaging in sport.