Autogenous non-vascularized fibula for treatment of giant cell tumor of distal end radius
- 242 Downloads
Giant cell tumor of distal end of radius is treated by wide resection and intralesional procedures with former having better results. The various modalities for the defect created are vascularized/non-vascularized bone graft, osteoarticular allografts and custom-made prosthesis. We report outcome of wide resection and non-vascularized fibular grafting in biopsy-proven giant cell tumors.
Patients and methods
Nine patients with mean age of 40 years with Campanacci grade II giant cell tumor of distal radius were managed with radical excision of the tumor and reconstruction with ipsilateral free fibular graft.
Mean follow-up time was 56 months. One patient developed recurrence and was treated by amputation. All other patients showed a good union at fibular graft–radius junction. In wrist, average range of motion achieved at last follow-up was 40° of dorsiflexion, 30° of palmar flexion, 45° each of supination and pronation. Major complications encountered included graft fracture (2), wrist subluxation (2), tourniquet palsy (1), aseptic graft resorption (1) and tumor recurrence (1).
Reconstruction after wide excision by non-vascularized fibular graft is a viable alternative for giant cell tumors of the lower end of radius though it is a challenging procedure and may be accompanied by major complications.
KeywordsNon-vascularized fibula Free fibula graft
- 1.Goldenberg RR, Campbell CJ, Bonfiglo M (1970) Giant-cell tumor of bone: an analysis of two hundred and eighteen cases. J Bone Joint Surg 52A:619–664Google Scholar
- 2.Campanacci M, Baldini N, Boriani S (1987) Giant-cell tumor of bone. J Bone Joint Surg 69A:106–114Google Scholar
- 3.Campbell CJ, Akbarnia BA (1975) Giant-cell tumor of the radius treated by massive resection and tibial bone graft. J Bone Joint Surg 57A:982–986Google Scholar
- 4.Gold AM (1965) Use of prosthesis for the distal portion of the radius following resection of a recurrent giant-cell tumor [follow-up note]. J Bone Joint Surg 47A:216–218Google Scholar
- 6.Murray JA, Schlafly B (1986) Giant-cell tumors in the distal end of the radius. Treatment by resection and fibular autograft interpositional arthrodesis. J Bone Joint Surg 68A:687–694Google Scholar
- 7.Pho RWH (1979) Free vascularised fibular transplant for replacement of the lower radius. J Bone Joint Surg 61B(3):362–365Google Scholar
- 8.Pho RWH (1981) Malignant giant-cell tumor of the distal end of the radius treated by free vascularized fibular transplant. J Bone Joint Surg 63A:877–884Google Scholar
- 10.Seradge H (1982) Distal ulnar translocation in the treatment of giant-cell tumors of the distal end of the radius. J Bone Joint Surg 64-A:67–73Google Scholar
- 11.Smith RJ, Mankin HJ (1977) Allograft replacement of distal radius for giant cell tumor. J Hand Surg 2:299–309Google Scholar
- 12.Campanacci M, Laus M, Boriani S (1979) Resection of the distal end of the radius. Italian J Orthop Traumatol 5:145–152Google Scholar
- 13.McDonald DJ, Sim FH, McLeod RA, Dahlin DC (1986) Giant-cell tumor of bone. J Bone Joint Surg 68-A:235–242Google Scholar
- 14.Vander Griend RA, Funderburk CH (1993) The treatment of giant-cell tumours of the distal part of the radius. J Bone Joint Surg 73A:899–908Google Scholar
- 16.Briggs TWR, Cobb J, McAuliffe T, Pringle J, Kemp H (1990) Giant cell tumours of bone. J Bone Joint Surg 72B:937Google Scholar
- 18.Shih HN, Chen YJ, Huang TJ et al (1996) Treatment of giant cell tumor of long bone. Chang Gung Med J 19:16–23Google Scholar