Functional Outcome of Giant Cell Tumor of Distal End Radius Treated with Excision and Fibular Bone Grafting

Abstract

Introduction: Giant Cell Tumors (GCT) comprise about 4-5% of all primary bone tumors and about 20% of benign bone lesions. GCT commonly affects the ends of long bones. The lower end of the radius is the third common site to be affected. The distal radius plays a significant role in  the  radio-carpal  articulation  and  hence  in  the  function  of  the  hand.  Various treatment modalities are advocated in the literature.  We have done wide excision and proximal fibula bone graft with temporary wrist arthrodesis by 2 different procedures. Materials and Methods: A prospective study including 6 cases of giant cell tumor of distal end of radius was conducted in KIMS, Karad from 2015 and 2018. All patients were evaluated preoperatively with plain radiograph and MRI of involved wrist. All the 6 patients were operated with wide excision, autogenous non-vascularised fibular graft and temporary wrist arthrodesis. Follow up included clinical and radiographic assessment and functional assessment using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Results: The mean follow-up period was 24 months (20–27) months. All patients achieved radiological union after a mean of 16weeks (14–20) weeks. The mean active range of movement in the operated wrists was 45º dorsiflexion, 15º palmar flexion, 10º radial deviation, 14º ulnar deviation. Conclusion: Wide excision and proximal fibula bone graft with temporary wrist arthrodesis has been found to be an effective method of treatment for Campanacci grade 2 Giant cell tumor of distal end radius.