Retrospective study of function outcome in giant cell tumor treated by sandwich technique with internal fixation
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 3
Abstract
Purpose: To evaluate outcomes of 27 patients who underwent curettage, use of phenol, and reconstruction using the sandwich technique with internal fixation with plate or k wires for giant cell tumor (GCT) of bone around the knee and ankle. Methods: 15 women and 12 men aged 19 to 46 (mean, 29.6) years underwent intralesional curettage, use of phenol, and reconstruction using the sandwich technique with internal fixatation with plate or k wires for GCT of the proximal tibia (n=12) or distal femur (n=13) or distal tibia (n=2). 1, 16, and 10 tumors were classified as grade I, grade II, and grade III, respectively. Four of the grade III tumors were associated with an extra-articular pathological fracture. Patients underwent intralesional curettage, use of phenol, and reconstruction with autograft (iliac crest), gel foam, and cement (the sandwich technique) with internal fixation with plates or k wires. Pathological fractures were fixed with plates. Results were based on serial radiographs showing consolidation of the lesion along with a subjective clinical examination and functional evaluation noted in the patient’s records. Functional outcome was evaluated using the Musculoskel et al Tumor Society (MSTS) score. Result: The mean follow-up period was 75.4 (60- 108) months. The mean MSTS score was 27.4 out of 30 (standard deviation, 3; range, 19–30). No patient had recurrence. No patient had malignant transformation. Conclusion: Intralesional curettage, use of phenol, and reconstruction with allograft, gel foam, and cement (the sandwich technique) for GCT of bone achieved good functional outcome and a low recurrence rate.
Authors and Affiliations
Dr. Anand Mohan Meena, Dr. Pankaj Jain, Dr. RL Dayma
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