Management of giant cell tumour of the distal end of the radius by en-block excision and reconstruction by free-autogenous graft using the upper end of the fibula

ABSTRACT

This study included 17 patients [6 women and 11 men with a mean age 36.5 years] with giant cell tumor [GCT] of the distal end of the radius treated by en-block resection and reconstruction by autogenous massive graft using the upper end of the fibula. The main presentation was pain; 13 patients complained of swelling as well 3 had undisplaced pathological fractures. In all patients, en-block excision of the lower end of the radius with a safety margin and removing the tumor with its pseudo capsule was carried out. The excised segment was replaced by a massive autograft from the upper end of the fibula. The graft was fixed to the remaining radius by a plate and screws and temporarily to the carpus or distal end of ulna by K wire or screw. The results showed that three patients developed a local recurrence, two had distant metastases and one patient was lost for follow up. Recurrent cases turned malignant. A functional study was done for the remaining 11 patients, which showed a good hand function and a slight limitation of wrist movement and almost normal pronation/supination. There was a widening of the wrist and no recurrence for an average of 18.1 years was detected