Giant Cell Tumor of Distal Radius: En Bloc Resection and Partial Wrist Arthrodesis Using Non-Vascularized Fibular Autograft

Background: Despite several surgical techniques introduced for the treatment of distal radial giant cell tumor (GCT), most appropriate treatments remain to be discovered. Objectives: The current study reported on the results of en bloc resection and partial wrist arthrodesis using non-vascularized fibular shaft. Methods: Between 2004 and 2014, 7 patients with distal radial GCT (Campanacci grade III) were treated by en bloc resection and partial wrist arthrodesis using non-vascularized fibular shaft. Arthrodesis was performed using an intramedullary pin. Patients were followed for 59 ± 38 months. At the last visit, active range of wrist motions, modified musculoskeletal tumor society (MSTS) scoring system, instability and grip strength compared to contralateral side were measured. Also, time of union, need for further operations and recurrence of the tumor were evaluated. Results: After 8.3 ± 0.5 months, complete union was achieved. The ranges of wrist flexion, wrist extension, ulnar deviation, radial deviation, supination, and pronation averaged 16.7 ± 2.6, 7.5 ± 6.1, 7.5 ± 6.1, 6.7 ± 5.2, 33.3 ± 6.8, and 30.8 ± 8.6 degrees, respectively. The mean modified MSTS score was 75.8 ± 8%. Grip strength was 53.3 ± 6.8% of the contralateral side. Graft-related complications did not occur. Recurrence occurred in 2 patients, including one bony recurrence at the graft-wrist junction and one soft tissue recurrence (28.6%). Conclusions: Replacement of excised distal radius with non-vascularized fibular shaft autograft following en bloc resection and partial arthrodesis, using an intramedullary pin, could serve as an appropriate treatment of distal radial GCT.