Functional outcome following excision of a tumour and reconstruction of the distal radius

Abstract

We retrospectively studied the functional and oncological results of 15 patients after reconstruction of the distal radius with osteoarticular allograft or non-vascularised fibular graft following wide excision of an aggressive benign or malignant tumour. Eight patients underwent osteoarticular allograft and seven patients had a non-vascularised autogenous fibular graft reconstruction. The average time for incorporation of the graft was 6 and 5 months in each reconstruction respectively. There was no tumour recurrence after follow up over 41.5-95.5 (average 60.5) months. All patients had good and excellent functional results. Three patients in the group reconstructed with osteoarticular allograft had plate loosening and graft fractures which were successfully treated subsequently.

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

“…Sheth et al [36] found comparable MSTS scores and grip strength when comparing intralesional excision and resection arthrodesis, respectively, for giant cell tumor of the distal radius in 26 patients. Some favorable functional results also have been reported for osteoarticular allograft reconstruction using proximal fibular autograft, however none were performed in our patients and there are concerns with high complication rates [1,3,6,23,24,26,31].…”

“…McGough et al [28] reported 30% recurrence in 33 patients, Harness and Mankin [18] reported 42% recurrence in 26 patients, Sheth et al [36] reported 25% recurrence in 12 patients, and O'Donnell et al [30] reported 50% recurrence in 10 patients. Conversely, en bloc resection of the distal radius with either arthrodesis or osteoarticular allograft has reported low recurrence rates of 0% [1,4,5,13,19,31,36,39], with few studies showing recurrence in greater than 25% [26,29].…”

Which Treatment is the Best for Giant Cell Tumors of the Distal Radius? A Meta-analysis

“…The best treatment approach for GCTs that occur in the distal radius is unclear. Recurrence rates have ranged from 25% to 89% for both procedures [1,4,29,35,41], although the recurrence rates for en bloc resection reportedly range from 0% to 33% [1,3,29,41]. In addition, en bloc resection usually requires sacrifice of the articular surface, and secondary arthritis has occurred in 13% to 50% of patients [8,13,16].…”

Reconstruction of the Distal Radius following Tumour Resection Using an Osteoarticular Allograft

“…Reconstruction is challenging due to the high functional demands on the hand. Common reconstruction techniques include arthrodesis with different autografts [1, 5–9], prosthetic replacement [10–13], ulnar translocation [5, 14], arthroplasty using (vascularised [8, 15] or nonvascularised [5, 16–18]) autologous fibula graft, or osteoarticular allograft reconstructions (Figure 1) [5, 16, 17, 19–25]. …”