Functional outcome in patient with giant cell tumour distal radius after reconstruction by en-bloc resection and non-vascularized fibular bone graft: a case report

Authors

  • Gede Agung Krisna Yudha Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia
  • I. Gede Eka Wiratnaya Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia
  • Dwiwahyonokusuma . Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia
  • I. Gede Mahardika Putra Department of Orthopaedic and Traumatology, Sanglah General Hospital, Udayana University, Bali, Indonesia

DOI:

https://doi.org/10.18203/2320-6012.ijrms20203689

Keywords:

Giant cell tumour, Distal radius, En-bloc resection, Fibular graft

Abstract

Giant cell tumor (GCT) is a relatively common benign primary bone tumor, commonly seen in end of long bones. Treatment goals for GCT of the distal radius are complete excision of the tumor and preservation of wrist function. Usually it can be treated by en-bloc resection and reconstruction using autogenous non vascularized ipsilateral proximal fibular graft. Authors present a case of twenty two years old female complaining of pain and lump in left wrist since two years ago. The pain worsened since 1 month before consultation, but did not radiate elsewhere. Pain was aggravated by movement and decreased with rest. Physical examination revealed a 3 cm mass with tenderness over left wrist. With clinical suspicion of benign bone tumor on left wrist, further evaluation was needed. Plain radiograph revealed an expansile, lytic lesion and soap bubble appearance on her left distal radius like a GCT. Open biopsy result revealed similar morphology with GCT. Reconstruction by en-bloc surgical excision, followed with non-vascularized fibular bone graft fixed with dynamic compression plate (DCP) and wrist ligament reconstruction and fixation of the head of the fibula with carpal bones and distal end of the ulna using K-wires along with palmaris longus tendon were performed. En-bloc resection of giant cell tumors of the lower end radius is a widely accepted method. Reconstruction with non-vascularized fibular graft, internal fixation with DCP with trans fixation of the fibular head and wrist ligament reconstruction minimizes the problem and gives satisfactory functional results.

References

Stevenson J, Parry M. Apley and Solomon’s system of orthopaedics and trauma. Tumours. 10th edition. Bristol. 2018;198-201.

Reid R, Banerjee SS, Sciot R. World Health Organization classification of tumours. Giant Cell Tumor. Lyon. 2002;310-2.

Robert KH, Patrick CT. Campbell’s operative orthopaedics. Benign/Aggressive tumors of bone. 13th edition. Philadelphia. 2017;923-5.

Maravi DS, Uikey S, Gaur S. Giant cell tumour of distal end radius: various treatment protocol and results. Orthop J M P. 2015;21(2):41-9.

Saini R, Bali K, Bachhal V, Mootha AK, Dhillon MS, Gill SS. En bloc excision and autogenous fibular reconstruction for aggressive giant cell tumor of distal radius: a report of 12 cases and review of literature. J Orthop Surg Res. 2011;6:14.

Humail SM, Ghulam MKK, Zaidi IH. Reconstruction of the distal radius with nonvascularised fibular graft after resection of giant cell tumour of bone. J Orthop Surg. 2014;22(3):356-9.

Malu RG, Jaju CR, Goyal V, Mali S, Nagoba V. Giant cell tumor of distal radius treated by en- bloc resection and reconstruction by non vascularized fibular graft. Eur J Gen Med. 2015;12(1):183-6.

Sau S, Biswas C. Clinical outcome of en-bloc resection of distal radius giant cell tumor and reconstruction by non-vascularized fibular graft and transosseous augmentation of wrist by palmaris longus tendon, an improvise technique. IOSR-JDMS. 2016;15(9):116-20.

Jafari D, Shariatzadeh H, Okhovatpour M, Razavipour M, Safdari F. Giant cell tumor of distal radius: en bloc resection and partial wrist arthrodesis using non vascularized fibular autograft. Shafa Orthop J. 2017;4:2.

Duan H, Zhang B, Yang HS, Liu YH, Zhang WL, Min L, et al. Functional outcome of en bloc resection and osteoarticular allograft reconstruction with locking compression plate for giant cell tumor of the distal radius. J Orthop Sci. 2013;18(4):599-604.

Downloads

Published

2020-08-26

How to Cite

Yudha, G. A. K., Wiratnaya, I. G. E., ., D., & Putra, I. G. M. (2020). Functional outcome in patient with giant cell tumour distal radius after reconstruction by en-bloc resection and non-vascularized fibular bone graft: a case report. International Journal of Research in Medical Sciences, 8(9), 3337–3340. https://doi.org/10.18203/2320-6012.ijrms20203689

Issue

Section

Case Reports