AbstractBackground and objectivesChondrosarcomas in flat bones are thought to be more aggressive in their behavior, and little is known about intralesional treatment outcomes of low‐grade chondrosarcoma in these locations. We tried to find the differences between patients who had low‐grade chondrosarcoma in their flat bones versus those with long bone involvement with regard to (1) disease outcome, (2) functional outcome, and (3) treatment complications.MethodsWe retrospectively reviewed 44 patients with primary low‐grade chondrosarcoma who were treated with intralesional curettage and cryotherapy. The patients were divided by location of tumor, group I (flat bones, seven patients) and group II (long bones, 37 patients).ResultsThe local recurrence rate was higher in group I with 5 years disease‐free survival of 80.0% in group I and 97.0% in group II (p = 0.001). All recurrent cases were noted to have initially presented with soft tissue extension (Enneking stage IB). The mean Musculoskeletal Tumor Society score at the last follow‐up was 21.7 in group I and 27.9 in group II (p = 0.045).ConclusionsIntralesional curettage and cryotherapy for low‐grade chondrosarcoma appear to be a safe and reasonable surgical option for patients with lesions confined to bone (Enneking stage IA).Level of evidenceLevel III, retrospective cohort study. See the Guidelines for Authors for a complete description of levels of evidence.