CORR ® Tumor Board: What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Twenty-one patients underwent excision of a Campanacci grade III giant cell tumour of the distal radius and had reconstruction using a proximal fibula autograft. We compared the functional results of wrist arthrodesis versus arthroplasty. All 21 patients healed in an average of 8 months, and all have remained disease free. The Musculoskeletal Tumor Society 93, the Disabilities of the Arm, Shoulder, and Hand scores and the grip strength of the operated wrist compared with the contralateral wrist were 93%, 7, and 71% for the arthrodesis group and 83%, 17, and 40% for the arthroplasty group. Arthrodesis of the reconstructed radiocarpal joint provided better grip strength and functional outcomes than arthroplasty. Level of evidence: III

Download Full-text

Giant Cell Tumor of Bone: 6 Years Institutional Retrospective Review

International Journal of Recent Surgical and Medical Sciences ◽

10.1055/s-0040-1712861 ◽

2020 ◽

Vol 6 (01) ◽

pp. 12-17

Author(s):

Nadeem Ali ◽

Dar Ghulam Nabi ◽

Azad Ahmad Shah ◽

Altaf Ahmad Kawoosa ◽

Mohammad Umar Mumtaz

Keyword(s):

Giant Cell ◽

Distal Radius ◽

Proximal Tibia ◽

Surgical Intervention ◽

En Bloc Resection ◽

Joint Involvement ◽

Common Site ◽

Giant Cell Tumors ◽

En Bloc ◽

Intralesional Curettage

Abstract Introduction Surgery is the cornerstone for the management of giant cell tumors (GCTs). There are no definite guidelines for the management. The purpose of this series was to study the patient demography and results of the surgical intervention for skeletal GCTs in our population. Materials and Methods All the histologically diagnosed cases of GCT of bone from year 2012 to 2018 were retrospectively analyzed for patient demographics, site, and grade of the lesion, type of biopsy taken (if any), nature of surgical intervention, and final outcome with respect to complications. Results Seventeen cases of skeletal GCT were diagnosed on histopathology. The mean age at presentation was 31.5 ± 10.9 years with females affected 1.4 times more. Proximal tibia was the most common site (29.4%) followed by distal radius and distal femur in that order. About 58.8% of the lesions were of Campanacci grade 2 and remaining were grade 3 lesions. Ten patients had extended curettage, five had en bloc resection, and one had amputation as the primary treatment. Twenty percent patients (n = 3) had local recurrence of the pathology and one patient developed distant recurrence (lung metastasis). Conclusion Proximal tibia followed by distal radius was the most common site of GCT in our population. The tumor behavior and recurrence cannot be predicted with any grading system. The goal should be salvage of the joint by intralesional curettage, with resection reserved for distal radius GCTs, cases with extensive soft tissue extension or those with destruction of the articular cartilage and joint involvement.

Download Full-text

Radius' Giant Cell Tumor: Allograft with Conservation of Distal Radioulnar Joint

Journal of Wrist Surgery ◽

10.1055/s-0039-1683364 ◽

2019 ◽

Vol 08 (03) ◽

pp. 215-220 ◽

Cited By ~ 1

Author(s):

S. Ruatti ◽

M. Boudissa ◽

P. Grobost ◽

G. Kerschbaumer ◽

J. Tonetti

Keyword(s):

Range Of Motion ◽

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

Functional Results ◽

Distal Radioulnar Joint ◽

Cell Tumor ◽

The Other ◽

Radioulnar Joint

Purpose Giant cell tumor of the distal radius are frequent lesions, and different types of surgeries have been described. Functional results, after conservative treatment or arthrodesis, often find a decreased strength and range of motion. The sacrifice of the distal radioulnar joint could be one of the causes. We report the case of a 26-year-old patient who presented with a Campanacci Grade III giant cell tumor of the distal radius. We managed his case by the association of en bloc resection and allograft reconstruction with the preservation of distal radioulnar joint. Hypothesis This procedure could improve functional results, without increasing the risk of recurrence at 2 years follow-up. Case Report The originality of our technique was the possibility of distal radioulnar joint conservation. We preserved a long portion of cortex bone all through the ulnar side of the distal radius. We then used an allograft of distal radius, fixed by a reconstruction anatomical plate. Results At 2 years follow-up, the range of motion was 100° with 60° of palmar flexion, 40° of extension, 75° of pronation, and 70° of supination. Radial and ulnar inclination were 10 and 15°, respectively. MTS (Musculoskeletal Tumor Society Score) 1993 was 88% and DASH score was 6. Concerning grip strength, it was measured at 85% in comparison with the other side. Pronation and supination strengths were 80 and 73%, respectively, in comparison with the other side. At follow-up, standard X-rays showed no recurrence. The allograft was well integrated. Conclusion Conservative treatment of the distal radioulnar joint allowed an almost ad integrum recovery, concerning strengths and range of motion. It allows a better functional recovery, without increasing the risk of recurrence.

Download Full-text

Oncologic and functional results after treatment of giant cell tumors of bone

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s004020100317 ◽

2001 ◽

Vol 122 (1) ◽

pp. 17-23 ◽

Cited By ~ 31

Author(s):

Harm W. Boons ◽

Lucien C. Keijser ◽

Bart H. Schreuder ◽

Maciej Pruszczynski ◽

Albert J. Lemmens ◽

...

Keyword(s):

Giant Cell ◽

Functional Results ◽

Giant Cell Tumors ◽

Tumors Of Bone

Download Full-text

Wrist Reconstruction Using Free Vascularized Fibular Head Graft Following Intralesional Excision for Campanacci Grade 3 Giant Cell Tumors Involving the Articular Surface of the Distal Radius

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2021.09.036 ◽

2021 ◽

Author(s):

Jong Hun Baek ◽

Duke Whan Chung ◽

Turki Alhassan ◽

Jae Hoon Lee

Keyword(s):

Giant Cell ◽

Distal Radius ◽

Articular Surface ◽

Fibular Head ◽

Giant Cell Tumors ◽

Grade 3

Download Full-text

The proximal fibular free flap - an ideal material for reconstructing distal radius defect after Giant tumor cell resection. A case report

Tạp chí Nghiên cứu Y học ◽

10.52852/tcncyh.v148i12.786 ◽

2021 ◽

Vol 148 (12) ◽

pp. 96-101

Author(s):

Duong Manh Chien ◽

Hoang Tuan Anh ◽

Nguyen Tran Quang Sang ◽

Phan Van Tan ◽

Nguyen Huu Trong ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

Free Flap ◽

Wrist Joint ◽

Cell Tumor ◽

Joint Function ◽

Giant Cell Tumors ◽

Tumor Excision ◽

Fibular Free Flap

Giant cell tumors (GCT) of the distal end of radius are relatively common tumors, representing approximately 5% of all primary bone tumors. It is the third most common location for GCT following distal femur and proximal tibia. In general, treatment includes thorough tumor excision, reconstruction of the defect, and wrist joint rehabilitation. The proximal fibular free flap is an ideal material for distal radius reconstruction after giant cell tumor excision. We present a case of a 57-year-old female, admitted to the hospital due to painful and limited proper wrist movement. Based on X-ray and Magnetic resonance imaging (MRI) images and histopathology findings, the patient was diagnosed with a stage 3 giant cell tumor of the distal radius. The patient underwent a one-step surgery of tumor excision and distal radius reconstruction by a vascularized proximal fibular free flap. 2 years follow-up post-surgery showed that the patient had no pain of the wrist, improved wrist joint function, no sign of recurrence, and good flap vitality and the knee joint remains normal. In conclusion, the surgery was successful with no further prolonged pain, improvement of the wrist joint function and overall improvement of the patient quality of life.

Download Full-text