Resection and reconstruction of distal radius Giant cell tumour using avascular autogenous fibular graft

Abstract

We report a case series of
four patients with giant cell tumour of the
distal end of the radius managed by wide
resection and reconstruction using fibular
autograft and its oncological and functional
outcome from January 2009 and
July 2011.There were 4 cases of GCT
involving distal radius managed by wide
resection and autogenous fibular bone
grafting with a mean age of 21 years. All
patients were Campanacci Grade III .
The mean follow up was 16.25 months
with a maximum follow up of 26 months.
The functional and oncological outcomes
of the patients were analysed. The functional
outcome of the patients were
evaluated using the Musculoskeletal tumour
society scoring the mean of which
was 22(range 18 to 26). . Three patients
showed clinical and radiological union.
Average palmar flexion of the wrist was
67 degrees (range 55 to 85) and dorsiflesion
was 50 degrees (range 20 to 70).
The mean supination achieved in our study
was 31 degrees(range 0-50) and the mean
pronation was 75 degrees( range 60-90).
None of our patients had a recurrence at
the surgical site or distant metastasis at the
time of latest follow-up. Stiffness was reported
in all the patients in our study which
was seen in most other studies. The results
we have are comparable to other studies
done with larger sample size. Reconstruction
of the distal radius with avascular autogenous
fibular graft after resection for a
Grade III Campanacci Giant cell tumor of
the distal radius provides adequate functional
restoration of the wrist with excellent
oncological outcome.