Distal ulnar translocation in the treatment of giant-cell tumors of the distal end of the radius.

Does Wrist Arthrodesis With Structural Iliac Crest Bone Graft After Wide Resection of Distal Radius Giant Cell Tumor Result in Satisfactory Function and Local Control?

“…These differ by the type of graft replacing the resected bone and whether an attempt is made to preserve the radiocarpal articulation. The autogenous grafts described include free vascularized fibula graft [20,25,33,35,38], nonvascularized fibula [6,37,44], vascularized structural iliac crest bone graft (ICBG) [21], nonvascularized ICBG [8], nonvascularized corticocancellous tibial struts [11,46], and use of the ulna adjacent to the involved radius [36,39]. Structural allograft [2,41,45] is a popular alternative in certain countries as well.…”

“…For the reconstructive technique chosen, these can be divided into those involving arthrodesis and those not. When arthrodesis is performed, this can be a total wrist arthrodesis with fixation of the native radius, the bridging graft, the carpus and a metacarpal, a total wrist arthrodesis with ulnocarpal fusion (when either ulnar centralization [39,47] or translocation [7,36,44] is performed), or a limited arthrodesis such as a fibulascapholunate arthrodesis [3,16]. Where arthrodesis is not performed, soft tissue reconstruction is performed to effect an osteoarticular reconstruction of the radiocarpal articulation.…”

Comparison of osteoarticular allograft reconstruction with and without the Sauvé–Kapandji procedure following tumour resection in distal radius

“…En bloc resection is strongly recommended for locally invasive benign lesions and for high-grade malignancies. Various techniques have been used for reconstruction following en bloc tumour resection including arthrodesis using autograft, 1,2 ulnar translocation, 3,4 use of non-vascularized or vascularized fibular graft with or without arthrodesis, 5e9 prosthetic replacement 10,11 and osteoarticular allograft arthroplasty. 12,13 All of these options have shown fair functional outcomes with regard to patient satisfaction or ability to return to normal life, but all have had a potentially high complication rate.…”

Custom prosthetic replacement for distal radial tumours

“…This poses a dual problem of skeletal reconstruction and functional restoration because of the high functional demands of the hand, the youth and long life expectancy of the patients especially in benign tumours, the limited surrounding soft tissue and the proximity of the adjacent nerves and tendons. The various procedures described include arthrodesis using bulk autograft [14], ulnar translocation [20], reconstruction with non-vascularised or vascularised fibular grafts [13,19], osteoarticular allograft [11], and prosthetic replacement [6]. Despite extensive experience with prosthetic replacement of juxta-articular tumours of the lower limb, there are few reports of prosthetic replacement of the distal radius along with any long-term outcome [9].…”