Management of a Case of Distal Ulna Giant Cell Tumor with Excision and Buttress Bone Grafting - A Case Report

Giant cell tumor (GCT) of the distal ulna is an extremely uncommon entity. These tumors are generally managed by excision ofthe tumor without any reconstruction. Simple excision of the tumor mass without any reconstructive procedure leads to ulnartranslation of the carpal bones and dynamic convergence of the ulna toward the radius. In our case, excision of GCT mass ofthe distal ulna in a 15-year-old boy was supplemented with reconstruction of the distal radioulnar joint by a 2 cm × 1 cm bonegraft and tenodesis of extensor carpi ulnaris to the ulnar stump. The patient achieved painless range of motion of his wrist jointby 5 months without any post-operative complications.

Stabilization of Ulnar Stump with Extensor Carpi Ulnaris: A Case Report.

Giant cell tumor (GCT) involving distal ulna being rare with reported rate of 0.45-3% of all GCT cases; the literature has only sporadic cases reported. Various treatment options have been proposed, and dilemma exist whether to do resection alone or resection combined with stabilization or reconstruction. Also, there is no conclusive evidence regarding the method of stabilization or reconstruction. A case of GCT of lower end ulna treated with excision of the distal end of ulna and stabilization of stump with extensor carpi ulnaris tendon slip in a 41-year-old female. The patient had an excellent functional outcome and no evidence of recurrence at 2 years of follow-up. Resection of ulna proximal to the insertion of pronator quadratus could lead to instability in the form of radio-ulnar convergence and winging of the ulnar stump and result in limitation of forearm rotation and weakness in grasping. Stabilization of the ulnar stump after resection for a GCT gave excellent results.

Giant Solitary Forearm Exostosis in A Child

Forearm deformity secondary to giant solitary ulna exostosis is rare. We describe a rare presentation of symptomatic solitary giant exostosis involving the entire distal ulna resulting in ulnar bowing of the forearm in a five year old boy. The tumour was completely resected and the defect was reconstructed with an allograft wrapped with a free autogenous periosteal tubular sleeve to deliver fresh pluripotential cells for better incorporation and integration. The distal ulna physes was preserved. An osteotomy was performed on the radius to correct the deformity. One year after surgery, the deformity remains corrected with normal bone length and excellent hand function. There is no evidence of local recurrence and the allograft has fully incorporated.