Abstract
BackgroundGiant cell tumors (GCTs) located in the distal radius are likely to recur, and the treatment of such recurrent tumors is very difficult. Here, we report our clinical experience in distal radius reconstruction with vascularized proximal fibular autografts after en-bloc excision of the entire distal radius in 17 patients with recurrent GCT (RGCT) of the distal radius.MethodsAll 17 patients with RGCT in distal radius underwent plain radiography and/or magnetic resonance imaging (MRI) of the distal radius as the initial evaluation after hospitalization. Then the distal radius were replaced by vascularized proximal fibular autografts after en-bloc RGCT resection. We assessed all patients by using clinical examinations, plain radiography of the wrist and chest, and Mayo wrist scores in the follow-ups.ResultsAfter an average follow-up of 4.3 years (range: 1.5–10.0 years), no lung metastasis or local recurrence was detected in any of the 17 patients. In total, 14 patients had excellent or good functional wrist scores, 16 were pain free or had occasional pain, and 15 patients returned to work. The mean range of motion of the wrist was 101° (flexion-extension), and the mean grip strength was 77.2 % of the contralateral normal hand.ConclusionEn-bloc excision of the entire distal radius and distal radius reconstruction with a vascularized proximal fibular autograft can effectively achieve local tumor control and preserve wrist function in patients with RGCT of the distal radius.
Highlights
Giant cell tumors (GCTs) located in the distal radius are likely to recur, and the treatment of such recurrent tumors is very difficult
GCT typically occurs in persons under the age of 40 years, and results in mild symptoms, which may continue for months before the patient visits an orthopedist; some GCT patients see a doctor for the first
Enbloc resection with some type of reconstruction surgery, ranging from arthrodesis to structural bone allograft/autograft replacement or wrist arthroplasty, which may reduce the rate of recurrence, can be effective in treating recurrent GCT (RGCT) in the distal radius [3, 5, 6]
Summary
Giant cell tumors (GCTs) located in the distal radius are likely to recur, and the treatment of such recurrent tumors is very difficult. Giant cell tumor (GCT), a type of primary benign bone tumor, is relatively common and usually involves the metaphyseoepiphyseal region of long bones in the extremities [1]. GCT in the distal radius is common and difficult to treat. Curettage is not a rational method for the management of primary GCT in the distal radius, let alone recurrent GCT (RGCT) in this site. Enbloc resection with some type of reconstruction surgery, ranging from arthrodesis to structural bone allograft/autograft replacement or wrist arthroplasty, which may reduce the rate of recurrence, can be effective in treating RGCT in the distal radius [3, 5, 6]
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