Distal radius reconstruction using a split vascularized fibula. Two cases following giant cell tumor resection

Giant cell tumor (GCT) of the distal radius is a rare and unpredictable lesion. The aim of treatment is complete removal of the tumor and preservation of the maximum function of the extremity. Lower rates of local recurrence have been noted after wide resection of the diseased bone. Its standard treatment has ranged from surgical curettage to wide resection. One method for closing the defect is using the head of the fibula as a substitute for the distal radius. The healing of vascularized fibular graft is very quick and without bone resorption. Thus, in the procedure for reconstruction and limb salvage after bone tumor resection of the distal radius, the free vascularized fibular graft with the fibular head is an ideal substitute. This case report will show a patient with GCT that successfully treated by an excision of GCT followed by reconstruction of distal radius using free vascularized fibular graft.

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Functional outcome of en bloc excision and custom prosthetic replacement for giant cell tumor of the distal radius

Journal of Orthopaedic Science ◽

10.1007/s00776-015-0763-z ◽

2015 ◽

Vol 20 (6) ◽

pp. 1090-1097 ◽

Cited By ~ 3

Author(s):

Shuai Zhang ◽

Mei-tao Xu ◽

Xu-quan Wang ◽

Jia-jia Wang

Keyword(s):

Functional Outcome ◽

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

Cell Tumor ◽

Prosthetic Replacement ◽

En Bloc ◽

En Bloc Excision ◽

Bloc Excision

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A Systematic Review and Meta-Analysis of En-Bloc vs Intralesional Resection for Giant Cell Tumor of Bone of the Distal Radius

The Open Orthopaedics Journal ◽

10.2174/1874325001307010103 ◽

2013 ◽

Vol 7 (1) ◽

pp. 103-108 ◽

Cited By ~ 15

Author(s):

Theresa J.C Pazionis ◽

Hussain Alradwan ◽

Benjamin M Deheshi ◽

Robert Turcotte ◽

Forough Farrokhyar ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

Wrist Joint ◽

Meta Analysis ◽

En Bloc Resection ◽

Cell Tumor ◽

En Bloc ◽

Intralesional Curettage ◽

Functional Benefit

Introduction: Surgical management of Giant Cell Tumor of Bone of the distal radius (GCTDR) remains controversial due to risk of local recurrence (LR) offset by functional limitations which result from en-bloc resection. This study aims to determine the oncologic and functional outcomes of wide excision (WE) vs intralesional curettage (IC) of GCTDR. Methods: A complete search of the applicable literature was done. Included studies reported on patients from the same cohort who were surgically treated for GCTDR with WE or IC. Two reviewers independently assessed all papers. The primary outcome measure was LR. Results: One-hundred-forty-one patients from six studies were included: 60 treated with WE, and 81 with IC. Five WE patients (8%) suffered LR whereas 25 IC patients (31%) did. The odds of LR were three times less in the WE group vs the IC group. MSTS1993 scores, where available, were on average 'good' with WE and 'excellent' with IC. Conclusions: Within statistical limitations the data support an attempt, where feasible, at wrist joint preservation and superior function with IC. Intralesional curettage is reasonable when the functional benefit outweighs the risk of recurrence as is the case in many cases of GCT of the distal radius.

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Giant Cell Tumor of Distal Radius Treated by En-Bloc Resection and Reconstruction by Non Vascularized Fibular Graft

Electronic Journal of General Medicine ◽

10.15197/sabad.1.12.39 ◽

2015 ◽

Vol 12 (2) ◽

Cited By ~ 1

Author(s):

Basavraj Nagoba ◽

Rajendra G. Malu ◽

Chetan R. Jaju ◽

Vishav Goyal ◽

Santosh Mali

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

En Bloc Resection ◽

Bloc Resection ◽

Cell Tumor ◽

Fibular Graft ◽

En Bloc ◽

Vascularized Fibular Graft

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Clinical and Radiographic Results of Reconstruction with Fibular Autograft for Distal Radius Giant Cell Tumor

Orthopaedic Surgery ◽

10.1111/os.12242 ◽

2016 ◽

Vol 8 (2) ◽

pp. 196-204 ◽

Cited By ~ 7

Author(s):

Dian-wen Qi ◽

Peng Wang ◽

Zhao-ming Ye ◽

Xiu-chun Yu ◽

Yong-cheng Hu ◽

...

Keyword(s):

Giant Cell Tumor ◽

Giant Cell ◽

Distal Radius ◽

Cell Tumor ◽

Fibular Autograft

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Ten-Year Follow-Up of Desarthrodesis of the Knee Joint 41 Years after Original Arthrodesis for a Bone Tumor

Case Reports in Orthopedics ◽

10.1155/2015/308127 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6

Author(s):

Ahmed Hamed Kassem Abdelaal ◽

Norio Yamamoto ◽

Katsuhiro Hayashi ◽

Akihiko Takeuchi ◽

Shinji Miwa ◽

...

Keyword(s):

Knee Joint ◽

Giant Cell Tumor ◽

Giant Cell ◽

Tumor Resection ◽

Cell Tumor ◽

Joint Surface ◽

Knee Arthrodesis ◽

Extensive Resection ◽

Complication Risk

Introduction. The main indication for knee arthrodesis in tumor surgery is a tumor that requires an extensive resection in which the joint surface cannot be preserved. We report a patient that had knee desarthrodesis 41 years after giant cell tumor resection followed by a knee arthrodesis. This is the longest reported follow-up after desarthrodesis and conversion to total knee arthroplasty (TKA), almost ten years.Case Report. A 71-year-old man with a distal femoral giant cell tumor had undergone a resection of the distal femur and knee arthrodesis using Kuntscher nail in 1962. In July 2003 he experienced gradually increasing pain of his left knee. We performed a desarthrodesis and conversion to TKA in 2005. The postoperative period passed uneventfully as his pain and gait improved, with gradually increasing range of motion (ROM) and no infection. He now walks independently, with no brace or contractures.Conclusion. Desarthrodesis of the knee joint and conversion to TKA are a difficult surgical choice with a high complication risk. However, our patient’s life style has improved, he has no pain, and he can ascend and descend stairs more easily. The surgeon has to be very meticulous in selecting a patient for knee arthrodesis and counseling them to realize that their expectations may not be achievable.

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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.

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