No abstract
BACKGROUND Osteoclastoma is associated with high morbidity and functional impairment. It can lead to complications of pathological fractures, recurrence and pulmonary metastasis. They typically occur in patients 20 to 40 years old and there is a slight female predominance. The most common location for this tumour is the distal femur followed closely by the proximal tibia. In the distal radius (the third most common location), these tumours frequently are more aggressive. This necessitates early intervention and restoration of biomechanical aspects of lower end of radius. MATERIALS AND METHODS 30 cases whose case histories, roentgenograms, histopathological reports, treatment modalities and their outcome were taken up, were treated with excision and reconstruction, fixation with Z cut and screws-3 cases, 1 case with rush nail, 5 cases with plate and screws, 18 cases with plate, screws and K-wires, 3 cases with acrylic prosthesis. Radiological grading done with Campanacci (1,2,3) grading. RESULTS The average duration of symptoms in this study was 2.36 months. Out of 30 patients 16 cases followup was done for more than 2 years, 14 patients were followed up for less than 2 years. Of the 27 cases of reconstruction with the fibular graft, we had 10 patients with recurrence. In the remaining 17 cases treated by reconstruction with fibular graft had no recurrence were separately looked for success of their biomechanical aspect of fixation. On evaluation of wrist movements 7 patients had fair range of movements, 6 patients with good range, 2 patients developed stiffness and 2 cases underwent arthrodesis. Of 17 cases hand function evaluation, 10 cases had good function, 6 cases had fair function and 1 case had poor function. Radiation treatment is advised in recurrent cases. CONCLUSION In this study we concluded that in various surgical procedures out of these plate, screws and K-wires had better functional outcomes compared to other procedures.
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