Abstract
This is a surgical technique report concerning the treatment of a 32-year-old male who had a giant cell tumor of distal ulna with suspected metastatic disease to the lungs. Three curettage procedures and a Darrach procedure were performed at an outlying facility. Upon the fourth reoccurrence, the patient was referred to our facility. It was established that the patient needed a distal ulna en bloc resection. To accommodate his activity requirements, reconstruction of the sigmoid notch and distal ulna was undertaken using a prosthesis. Soft tissue stabilization of the prosthesis was a challenge due to his previous procedures. This was accomplished using a brachioradialis tendon wrap.
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References
Bieber EJ, Linschied RL, Dobyns JH, Beckenbaugh RD. Failed distal ulna resections. J Hand Surg [Am]. 1988;13A:193–2000.
Campanacci M, Baldini N, Boriani S, Sudanese A. Giant cell tumor of bone. J Bone Surg. 1987;69A:106–14.
Ferracini R, Masterson EL, Bell RS, Wunder JS. Distal ulnar tumors. Results of management by en bloc resection in nine patients and review of the literature. J Hand Surg. 1998;23B:517–21.
Gordon KE, Dunning CE, Johnson JA, King GJW. Kinematics of ulnar head arthroplasty. J Hand Surg. 2003;28B:551–8.
Harness NG, Mankin HJ. Giant cell tumor of the distal forearm. J Hand Surg. 2004;29A:188–93.
Jaffe HL, Lichenstein L, Portis RB. Giant cell tumor of bone; its pathologic appearance, grading, supposed variants and treatment. Arch Pathol Lab Med. 1940;30:993–1031.
Kay RM, Echardt JJ, Seeger LL, Mirra JM, Hak DJ. Pulmonary metastasis of benign giant cell tumor of bone; six histologically confirmed including of one of spontaneous regression. Clin Orthop Relat Res. 1994;302:219–30.
Newmeyer WL, Green DP. Rupture of digital extensor tendons following distal ulnar resection. J Bone Joint Surg. 1982;64A:178–82.
Noble J, Arafa M. Stabilization of distal ulna after excessive Darrach’s procedures. Hand 1983;15:70–2. doi:10.1016/S0072-968X(83)80038-2.
Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop Relat Res. 1984;187:26–35.
Rock M. Curettage of giant cell tumor of bone: factors influencing local recurrences and metastasis. Chir Organi Mov. 1990;75(Suppl1):204–5.
Roidis NT, Gorgoulias NE, Paraskevi LD, Konstantinos MN. Distal ulnar implant arthroplasty as a definitive treatment of a recurrent giant-cell tumor. J Hand Surg. 2007;32A:1262–6.
Sienbenrock KA, Unni KK, Rock G. Giant-cell tumour of bone metastasizing to the lungs. J Bone Jt Surg. 1998;80B:43–7.
Tubbs WS, Brown LR, Beabout JW, Rock MG, Unni KK. Benign giant cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases. AJR Am J Roentgenol. 1992;158:331–4.
van Schoonhoven J, Fernandez DL, Bowers WH, Herbert TJ. Salvage of failed resection arthroplasties of the distal radioulnar joint using new ulnar head prosthesis. J Hand Surg. 2000;25A:438–46.
Wurapa RK, Whipple R. Distal radioulnar allograft reconstruction after giant cell tumor resection. Am J Orthop. 2003;32:397–400. doi:10.1007/s00132-003-0463-9.
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Dr. Amit Gupta is a consultant and stock owner of Small Bone Innovations. Dr. Amit Gupta and Dr. Peter Buecker are both staff members affiliated with the University of Louisville. Dr. Charity Burke is a resident affiliated with the University of Louisville. There was no institutional or corporate funding of this paper.
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Burke, C.S., Gupta, A. & Buecker, P. Distal Ulna Giant Cell Tumor Resection with Reconstruction using Distal Ulna Prosthesis and Brachioradialis Wrap Soft Tissue Stabilization. HAND 4, 410–414 (2009). https://doi.org/10.1007/s11552-009-9192-9
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DOI: https://doi.org/10.1007/s11552-009-9192-9