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European Journal of Orthopaedic Surgery & Traumatology

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01-08-2020 | giant cell tumor | Original Article

Functional outcome in giant cell tumor of distal radius treated with excision and fibular arthroplasty: a case series

Authors: Sitanshu Barik, Aakriti Jain, Sabeel Ahmad, Vivek Singh

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 6/2020

Abstract

Introduction

Giant cell tumor (GCT) of bone is a locally aggressive benign neoplasm that is associated with a wide spectrum of biological activity ranging from latent benign to highly recurrent and has occasional metastatic potential. It affects the meta-epiphyseal region of long bones of young adults with most common site involved is the distal femur, followed by the distal radius. Plain radiographs and contrast-enhanced magnetic resonance imaging are the imaging modalities widely used followed by definite histopathology for diagnosis. Surgical treatment with curettage is considered optimal for local tumor control. Tumor excision with tumor-free margins is associated with lesser recurrence rates; however, for periarticular lesions this is usually accompanied with a suboptimal functional outcome.

Methods

Eleven eligible patients (all females, mean age 39.2 years) with Campanacci grade III GCT of the distal radius who were treated by en bloc resection and reconstruction with non‐vascularized proximal fibular autografts at a single centre between July 2016 and December 2017 were included in the study. The patients had a clinical and radiographic review every month for the first 6 months, then biannually for minimum of 2 years. The functional, oncologic and radiological outcomes of the patients were analyzed and recorded.

Results

The mean duration of follow‐up was 31.9 months. Bony union was achieved in all cases. The mean VAS score at 6 months was 1.1 (range 0–2). The mean Mayo Wrist score was 66.36 (range 55–80) with mean MSTS score was 21.09 (range 18–24). The average range of motion of the wrist was: 37.3° ± 6.9° of flexion, 47.1° ± 7.5° of extension, 57.3° ± 7.8° of supination and 63.6° ± 6.4° of pronation. The average graft length used was 15.6 cm. The complications noted were lung metastases which developed preoperatively, local site recurrence, wrist joint subluxation, foot drop and wound complication.

Discussion and conclusions

The primary aim of treating GCT distal radius is oncologically sound resection with good functional outcome and cosmesis being secondary. Reconstruction with a non‐vascularized proximal fibular autograft is a reasonable option after en bloc resection of the distal radius for giant cell tumor of bone having comparable results with other treatment modalities.

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Title: Functional outcome in giant cell tumor of distal radius treated with excision and fibular arthroplasty: a case series
Authors: Sitanshu Barik
Aakriti Jain
Sabeel Ahmad
Vivek Singh
Publication date: 01-08-2020
Publisher: Springer Paris
Keyword: giant cell tumor
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 6/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02679-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Functional outcome in giant cell tumor of distal radius treated with excision and fibular arthroplasty: a case series

Abstract

Introduction

Methods

Results

Discussion and conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion and conclusions

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