En bloc resection and vascularized ulnar pedicle graft reconstruction with plate fixation for giant cell tumour of the distal radius

Abstract

We retrospectively reviewed the medical records of ten patients (five men and five women) who were treated in our unit for Campanacci Grade III giant cell tumour of the distal radius between July 2017 and December 2019. Following en bloc resection of a giant cell tumour of the distal radius, the wrist was reconstructed by transposing a vascularized pedicle graft from the ipsilateral ulnar shaft. The graft was fixed to the radial shaft and proximal carpal row with plates. At a mean follow-up of 23.5 months (range 18 to 31), bony union was achieved in all cases and there were no tumour recurrences. All patients had a good range of pronation and supination, but flexion and extension of the wrist was limited. DASH scores ranged from 5 to 11. This reconstruction method is a safe and effective procedure that provides good aesthetic outcomes, removes the need for microvascular techniques and reduces donor site morbidity. Level of evidence: IV

Outcomes of distal radial endoprostheses for tumour reconstruction: a single centre experience over 15 years

“…Reconstructive options include biological materials, such as vascularized and non-vascularized fibular autograft, ulnar translocation and iliac crest bone grafting, or custom endoprosthesis (Chobpenthai et al., 2022; Gulia et al., 2019; Kocher et al., 1998; Lackman et al., 1987; Leung and Chan, 1986; Natarajan et al., 2009; Pho, 1981; van de Sande et al., 2013; Yamamoto et al., 2002; Zhang et al., 2017). Heterogeneity of the defects, and variable patient functional requirements, mean there is no defined best reconstructive option.…”