Functional outcome of en bloc resection and osteoarticular allograft reconstruction with locking compression plate for g
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ORIGINAL ARTICLE
Functional outcome of en bloc resection and osteoarticular allograft reconstruction with locking compression plate for giant cell tumor of the distal radius Hong Duan • Bin Zhang • Hong-sheng Yang Yue-hui Liu • Wen-li Zhang • Li Min • Chong-qi Tu • Fu-xing Pei
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Received: 14 July 2012 / Accepted: 4 April 2013 / Published online: 10 May 2013 Ó The Japanese Orthopaedic Association 2013
Abstract Background Giant cell tumors of the distal radius at Campanacci grade III are particularly challenging to treat. We have treated 15 cases of giant cell tumor of the distal radius by en bloc excision and osteoarticular allograft reconstruction with locking compression plate (LCP). The purpose of this study was to assess the intermediate outcomes of all patients treated with this surgery. Methods From July 2002 to January 2009, we followed up 15 patients with giant cell tumors of the distal radius who were treated with en bloc excision and osteoarticular allograft reconstruction with LCPs that were long enough to approach the distal end of the allograft. All of the cases were evaluated based on clinical and radiologic examinations, the passive range of motion of the wrist joint, complications, Mayo wrist score, and short form (SF)-36. Results The clinical follow-up time after reconstruction averaged 5.2 years. The mean resected length of the radius was 8.1 cm. One patient had tumor recurrence in the soft tissues after 3 years (recurrence rate 6.67 %). No patient had allograft bone fracture, nonunion, or metastases. Subchondral bone alterations and joint narrowing were present in all cases, with 1 patient suffering from the pain, but the pain could be endured without the need for analgesics. The average range of motion of the wrist was 46.7° of dorsiflexion, 33.3° of volar flexion, 61.3° of supination, and 72.3° of pronation. The mean Mayo wrist score was 70 and the mean modified SF-36 score was 71.
H. Duan B. Zhang H. Yang Y. Liu W. Zhang L. Min C. Tu (&) F. Pei Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, People’s Republic of China e-mail: [email protected]
Conclusions En bloc excision and osteoarticular allograft reconstruction with an appropriate LCP for a Campanacci grade III giant cell tumor of the distal radius result in a reasonable functional outcome at intermediate follow-up evaluation. This method can excise the tumor integrally with a low rate of recurrence, good function, and a satisfactory range of motion.
Introduction The distal radius is an unusual site for primary bone tumor, but approximately 10 % of all giant cell tumors occur in the distal radius, which is the third most common location of giant cell tumors [1–3]. Giant cell tumors of the distal radius are particularly challenging to treat because of late detection, the limited surrounding soft tissue, and the proximity of adjacent nerves and tendons, and because there is often cortical breakthrough [4]. Because of the frequency of recurrence after curettage in Camp
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