ABSTRACT
Giant cell tumour is a benign tumour of the bone. It is aggressive locally and has low metastatic potential.(1) Following lower end of femur and upper tibia, distal end of radius is the third most evident location for giant cell tumour (GCT) and about 10 percent of GCT involves distal radius.(2) GCT have often been identified as difficult to manage, mainly due to their close proximity to multiple tendons, median nerves, radial arteries and carpals.(3) Surgical treatment includes extended curettage of bone and replacing the cavity with bone graft, or excision of the tumour followed by reconstruction of bone with autograft or allograft.(1) Wrist fusion after ulnar translocation results in reduced range of pronation and supination movements in the forearm initially and mainly flexion and extension of the wrist joint, lag of the extensor pollicis brevis and longus tendons, abductor pollicis longus, stiffness and the risk of infections at the site.(6) Physiotherapy has been shown to be effective in the post-surgery treatment of patients. Nonetheless, the therapeutic program involves passive movement to active movements, manual joint mobilization, progressive resisted exercises, muscle energy technique and electrotherapy with adequate patient education. This has been shown to help improve patient outcomes and alleviate pain and recover full range of motion.(7)The distal end of the radius is the third most apparent site for giant cell tumour (GCT) after the lower end of the femur and upper tibia and about 10 per cent of GCT includes distal radius. After ulnar translocation and wrist arthrodesis the full range of motion cannot be regained at the wrist joint and which makes the case unique, physical therapy has been shown to be helpful for improving patient performance and quality of life in post-surgical situations. Patient main concerns were pain and oedema around wrist with loss of strength, power and range of motion. Main clinical findings found in this case were severe reduction in of range of motion at CMC, MCP and IP joints. Reduced strength in hand muscles. Loss of superficial sensation over C6, C7 in affected extremity (right). Giant Cell Tumour that was confirmed by X-Ray and histopathology as well as MRI. Nerve injury confirmed by Nerve Conduction Velocity. Therapeutic interventions are found to be beneficial in these type cases. The patient was able to achieve 4/6 activities of daily living and gain functional range of motion after continuous 10 weeks of intensive systematic physiotherapy treatment program.