Abstract
Introduction
Giant cell tumor of the distal fibula is a very rare condition. The treatment of advanced tumors at this location can be challenging and has been described in the literature only in single cases.
Materials and methods
We report on a patient with a stage III giant cell tumor, according to the classification of Campanacci, of the distal fibula after en bloc resection and distal fibula reconstruction with a long bone graft from the iliac crest in a second procedure. The syndesmosis was reconstructed with a periosteal flap, the capsule and ligaments with local scar tissue.
Results
Fifteen years after the initial treatment the patient is free of local recurrence and demonstrates an excellent clinical outcome without any signs of instability, loss of function or osteoarthritis of the ankle joint.
Conclusion
We suggest the method to be worthwhile for treatment of this uncommon lesion in terms of recurrence and functional outcome.
References
Babhulkar SS, Pande KC, Babhulkar S (1995) Ankle instability after fibular resection. J Bone Joint Surg [AM] 77-A:258–261
Bini SA, Gill K, Johnston JO (1995) Giant cell tumor of bone. Curettage and cement reconstruction. Clin Orthop 321:245–250
Campanacci M, Baldini N, Boriani S, Sudanese A (1987) Giant-cell tumor of bone. J Bone Joint Surg [AM] 69-A:106–114
Capanna R, Fabbri N, Bettelli (1990) Currettage of giant cell tumor of bone. The effect of surgical technique and adjuvants on local recurrence rate. Chir Org Mov 75:206
Caplan AI, Elyaderani M, Mochizuki Y, Wakitani S, Goldberg VM (1997) Principles of cartilage repair and regeneration. Clin Orthop 342:254–269
Casadei R, Ruggieri P, Moscato M, Ferraro A, Picci P (1996) Aneurysmal bone cyst and giant cell tumor of the foot. Foot Ankle Int 17:487–495
Doga AS, Kulkari SS, Bhosale PB. Distal fibular giant cell tumor (1995) J Postgrad Med 41:83–84
Dreinhöfer KE, Rydholm A, Bauer HC, Kreichbergs A (1995) Giant-cell tumors with fracture at diagnosis. J Bone Joint Surg [BR] 77-B:189–193
Gitelis S, Mallin BA, Piasecki P, Turner F (1993) Intralesional excision compared with en bloc resection for giant-cell tumors of bone. J Bone Joint Surg [AM] 75-A:1648–1654
Goh JCH, Mech AM, Lee EH, Ang EJ, Bayon P, Pho RWH (1992) Biomechanical study on the load-bearing characteristics of the fibula and the effect of fibular resection. Clin Orthop 279:223–228
Goldenberg RR, Campbell CJ, Bonfiglio M (1970) Giant-cell tumor of bone. J Bone Joint Surg [AM] 52-A:619–664
Labs K, Perka C, Schmidt RG (2001) Treatment of stages 2 and 3 giant-cell tumor. Arch Orthop Trauma Surg 121:83–86
Marcove RC (1977) En-bloc resection for osteogenic sarcoma. Can J Surg 20:521–528
Martinez JC, Acha JG, Galarraga JIG, Andueza JMS (1993) En-bloc resection of the distal fibula for aneurysmal bone cyst. Acta Orthop Belg 59:87–89
McDonald DJ, Sim FH, McLeod RA, Dahlin DC (1986) Giant-cell tumor of bone. J Bone Joint Surg [AM] 68-A:235–242
O’Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ (1994) Recurrence of giant-cell tumors of the long bones after curettage and packing with Cement. J Bone Joint Surg [AM] 76-A:1827–1833
O’Keefe RJ, O’Donnell RJ, Temple HT, Scully SP, Mankin HJ (1995) Giant cell tumor of bone in the foot and ankle. Foot Ankle Int 16:617–623
Rock M (1990) Curettage of giant cell tumor of bone. Factors influencing local recurrences and metastasis. Chir Org Mov 75:204–205
Sung HW, Kuo DP, Shu WP, Chai YB, Liu CC, Li SM (1982) Giant-cell tumor of bone: Analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg [AM] 64-A:755–761
Walling AK, Gasser SI. (1994) Soft-tissue and bone tumors about the foot and ankle. Clin Sports Med 13:909–938
Wülling M, Engels C, Jesse N, Werner M, Delling G, Kaiser E (2001) The nature of giant cell tumor of bone. J Cancer Res Clin Oncol 127:467–474
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Eger, W., Schörle, C. & Zeiler, G. Giant cell tumor of the distal fibula: fifteen-year result after en bloc resection and fibula reconstruction. Arch Orthop Trauma Surg 124, 56–59 (2004). https://doi.org/10.1007/s00402-003-0562-4
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-003-0562-4