Multiple enchondromatosis (Ollier's disease)

Understanding Ollier’s Disease

Ollier’s disease (multiple enchondromatosis) is a rare, non-hereditary condition in which multiple benign cartilage tumours called enchondromas grow within bones. In Ollier’s disease, these tend to cluster in the small bones of the hands and feet (phalanges and metacarpals) and in the long bones. Enchondromas in Ollier’s disease are benign — they are not cancerous. However, they can weaken bones, cause deformity, and, when located in the fingers, impair function and grip.

What does the operation involve?

The operation involves carefully removing the enchondroma from the affected phalanx (finger bone) and, where necessary, filling the resulting cavity with bone graft material to restore bone strength and support healing.

Benefits of surgery

• Removes the tumour and relieves pressure within the bone

• Reduces risk of pathological fracture (a fracture through weakened bone)

• Corrects or prevents progressive finger deformity

• Restores bone strength over time as graft incorporates

• Improves or preserves finger function and grip

• Provides tissue for histopathological confirmation that the tumour is benign

Risks and possible complications

All surgical procedures carry risks. Mr Wadia will discuss these with you individually.

General risks

• Wound infection — managed with antibiotics if required

• Bleeding or haematoma (collection of blood under the skin)

• Anaesthetic risks — discussed separately with the anaesthetist

• Scarring

Procedure-specific risks

• Recurrence of the enchondroma — incomplete curettage is the main cause; meticulous technique minimises this risk

• Pathological fracture — the bone is weakened during surgery; splinting and activity restriction during healing reduces this risk

• Graft resorption or failure to incorporate — uncommon; usually managed with further grafting if significant

• Finger stiffness — prevented by early physiotherapy and movement once wound healed

• Injury to digital nerves or tendons — structures are identified and protected throughout

• Donor site morbidity — if autograft is used, there will be a second small wound at the harvest site

Are there alternatives?

Not all enchondromas need removing. Only symptomatic ones need excision. Most can be safely observed.

Bone graft choice:

Bone grafting with autograft

Uses your child’s own bone. No rejection   risk but requires a second harvest site.

Bone grafting with allograft or synthetic   substitute

Avoids a second wound. Equivalent outcomes   in most cases. Mr Wadia will advise.

Recovery

Important — activity restrictions

• Your child must not use the operated finger(s) for gripping or loading activities until the bone graft has incorporated — usually 6-8 weeks

• A protective splint will be provided and should be worn as directed

• Finger movement (gentle flexion/extension exercises) is encouraged as soon as comfortable to prevent stiffness

• Contact sports must be avoided until X-ray confirms graft incorporation

Long-term management of Ollier’s disease

Note:Surveillance — important for Ollier’s disease 

Ollier’s disease is a lifelong condition. The enchondromas removed at any operation are not the only ones your child may have. Regular clinical and radiological surveillance is recommended to monitor for new or enlarging lesions in other bones. Your child should be reviewed at least annually in a specialist paediatric orthopaedic clinic. Any new pain, swelling, or deformity in any bone should be reported promptly for assessment. 

Note: Red flags — contact the department or attend your nearest A&E or call NHS 111 urgently if: - Sudden severe pain in the finger with or without minor injury (may indicate fracture through the graft) - Significant swelling, redness, or wound discharge beyond the first week - Temperature above 38.5 degrees C - Numbness or inability to move the finger

This information is for general guidance only and is not a substitute for a consultation with Mr Wadia. If you are worried about your child, please seek medical advice.