Abstract
Thirty giant cell tumors of the distal radius were excised and reconstructed using a nonvascular fibular osteoarticular autograft. Four different surgical techniques for stabilization were used. There were ten recurrences, which could not be correlated with Campanacci's radiological or Jaffe's histological grading. Twenty cases without recurrence were followed up over 1.5–25.5 (average 8.5) years. Average time for incorporation of the graft was 5.2 months. The surgical technique using a radiofibular plate and K wire through the wrist had a low nonunion rate, no graft related complications, good range of movement, and good hand functions.
Résumé
Trente tumeurs à cellules géantes du radius distal ont été excisées avec reconstruction par une autogreffe ostéo-articulaire fibulaire non-vascularisée. Quatre techniques chirurgicales différentes ont été utilisées pour la stabilisation. Il y avait 10 récidives non correlées avec la classification radiologique de Campanacci ou celle, histologique, de Jaffe. Vingt cas sans récidive ont été suivis de 1,5 à 25,5 années (moyenne 8,5 années). Le temps moyen pour l'incorporation de la greffe était de 5,2 mois. La technique chirurgicale utilisant une plaque radio-fibulaire et une broche de Kirchner trans-carpienne avait un faible taux de non-consolidation, aucune complications liée à la greffe, une bonne amplitude de mouvement et une bonne fonction de la main.
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References
Campanacci M, Baldini N, Boriani S, Sudanese A (1987) Giant-cell tumor of bone. J Bone Joint Surg [Am] 69: 106–114
Cheng CY, Shih HN, Hsu KY, Hsu RW (2001) Treatment of giant cell tumor of the distal radius. Clin Orthop 383: 221–228
Enneking WF (1983) Musculoskeletal tumor surgery, vol 2. Churchill Livingstone, New York
Goldenberg RR, Campbell CJ, Bonfiglio M (1970) Giant cell tumor of bone. An analysis of two hundred and eighteen cases. J Bone Joint Surg [Am] 52: 619–664
Kumta SM, Leung PC, Yip K, Hung LK, Panozzo A, Kew J (1998) Vascularized bone grafts in the treatment of juxta-articular giant-cell tumors of the bone. J Reconstr Microsurg 14: 185–190
Lackman RD, McDonald DJ, Beckenbaugh RD, Sim FH (1987) Fibular reconstruction for giant cell tumor of the distal radius. Clin Orthop 218: 232–238
Lausten GS, Jensen PK, Schiødt T, Lund B (1996) Local recurrences in giant cell tumour of bone. Long-term followup of 31 cases. Int Orthop 20: 172–176
Lawson TL (1952) Fibular transplant for osteoclastoma of the radius. J Bone Joint Surg [Br] 34: 74–75
Leung PC, Chan KT (1986) Giant cell tumor of the distal radius treated by resection and free vascularized iliac crest graft. Clin Orthop 202: 232–236
Mack GR, Lichtman DM, MacDonald Rl (1979) Fibular autografts for distal defects of the radius. J Hand Surg [Am] 4: 576–583
Minami A, Kutsumi K, Takeda N, Kaneda K (1995) Vascularised fibular graft for bone reconstruction of the extremities after tumor resection in limb-saving procedures. Microsurgery 16: 56–64
Minami A, Kato H, Iwasaki N (2002) Vascularized fibular graft after excision of giant-cell tumor of the distal radius: wrist arthroplasty versus partial wrist arthrodesis. Plast Reconstr Surg 110: 112–117
Okada T, Tsukada S, Obara K, Yasuda Y, Kitayama Y (1981) Free vascularised fibular graft for replacement of the radius after excision of giant cell tumor. J Microsurg 3: 48–53
Ono H, Yajima H, Mizumoto S, Miyauchi Y, Mii Y, Tamai S (1997) Vascularized fibular graft for reconstruction of the wrist after excision of giant cell tumor. Plast Reconstr Surg 99: 1086–1093
Pho RWH (1979) Free vascularised fibular transplant for replacement of the lower radius. J Bone Joint Surg [Br] 61: 362–365
Pho RWH (1981) Malignant giant cell tumor of the distal end of the radius treated by a free vascularised fibular transplant. J Bone Joint Surg [Am] 63: 877–884
Rooney RJ, Asirvatham R, Lifeso RM, Ali MA, Parikh S (1993) Giant cell tumor of bone. A surgical approach to grade III tumours. Int Orthop 17: 87–92
Sheth DS, Healy JH, Sobel M, Lane JM, Marcove RC (1995) Giant cell tumor of the distal radius. J Hand Surg [Am] 20: 432–440
Tuli SM (1972) Bridging of bone defects by massive bone grafts in tumorous conditions and in osteomyelitis. Clin Orthop 87: 60–73
Van Demark RE Jr, Van Demark RE Sr (1988) Nonvascularized fibular autograft to treat recurrent giant cell tumor of the distal radius. J Hand Surg (Am) 13: 671–675
Vander Griend RA, Funderburk CH (1993) The treatment of giant-cell tumors of the distal part of the radius. J Bone Joint Surg (Am) 75: 899–908
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Work done at Kasturba Medical College and Hospital, Manipal, India.
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Aithal, V.K., Bhaskaranand, K. Reconstruction of the distal radius by fibula following excision of giant cell tumor. International Orthopaedics (SICOT) 27, 110–113 (2003). https://doi.org/10.1007/s00264-002-0414-9
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DOI: https://doi.org/10.1007/s00264-002-0414-9