Wrist Arthroplasty using Non-Vascularized Fibular Graft in Giant Cell Tumor of Radius – A Clinical Evaluation Report
Journal Title: Kerala Journal of Orthopaedics - Year 2018, Vol 0, Issue 0
Abstract
Introduction: Giant cell tumor (GCT) of distal radius is infamous for its aggressive nature. Although en bloc excision remains the aim of treatment, reconstruction of the iatrogenic defect created remains a major challenge. We, here, present our experience with wrist reconstruction using non-vascularized fibula grafting in distal radius GCT. Materials and Methods: A total of 11 patients with a mean age of 29 years (24–35 years) with distal radius GCT were treated by wide resection and non-vascularized fibular grafting. Eight cases underwent fixation of ipsilateral fibula to the remnant radius with 3.5 mm dynamic compression plate, and three cases underwent side-to-side fixation with screws alone. Results: Mean follow-up period was 4 years (6.2–2.7 years). The average time of bone union at radiofibular junction was 30 weeks (18–58 weeks). The average range of movements was 60° (35°–75°) of forearm supination, 50° (20°–60°) of forearm pronation, 50° (30°–80°) of wrist palmar flexion, and 60° (20°–70°) of wrist dorsiflexion. Mean grip strength of involved side as a percentage of normal side was 65% (42–86%). The overall revised Musculoskeletal Tumor Society score averaged 90%. We had one case of graft fracture, one case of screw loosening and implant failure, and two cases of fibula carpal subluxation postoperatively. Conclusion: Wrist arthroplasty using non-vascularized fibula grafting gives satisfactory and promising results both cosmetically and functionally after en bloc excision of distal radius GCT.
Authors and Affiliations
Nikhil CS Nikhil CS, Nithin M Nithin M, Mani N J Mani N J, Muraleedharan K D Muraleedharan K D
Keywords
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