Modified Sauve-Kapandji Procedure Using Iliac Bone Graft for Giant Cell Tumor of the Distal Ulna: Stabilizing With Two-Screw Fixation

Tsai, Ting-Chien; Chen, Chia Ling; Huang, Hui‐Kuang; Wang, Jung-Pan

doi:10.2106/jbjs.cc.18.00299

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…4 To avoid the complications related to wrist instability and DRUJ after resection of GCT distal ulna, many procedures have been described in the literature. Harness and Mankin 2 recommended iliac bone graft as ulnar buttress which was also performed by Hashizume et al, 25 Naik et al, 26 and Tsai et al 27 Wurapa and Whipple 28 reconstructed the DRUJ with twostage allograft. Some authors have combined the ECU tenodesis with iliac crest graft to the distal radius.…”

Section: Discussionmentioning

confidence: 99%

Clinical and functional outcomes of reconstruction following en bloc resection for the Campanacci grade III distal ulnar giant cell tumors

Kumar

Rustagi

Talwar

et al. 2022

Journal of Orthopaedics, Trauma and Rehabilitation

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Background: Wide resection of the tumor is essential for the treatment of Campanacci grade III giant cell tumor of the distal ulna but radioulnar convergence and dorsal displacement of the ulnar stump are known complications. Various reconstructive options to reduce these complications have been described in the literature. Methods: Seven patients with Campanacci grade III giant cell tumor distal end of the ulna were treated at our institute by extra-periosteal wide local excision of the tumor followed by reconstruction of the distal radioulnar joint by fixation of tricortical iliac crest graft to the distal end radius using two cancellous screws and extensor carpi ulnaris (ECU) tenodesis for stabilizing the residual ulnar stump. All patients were followed up for an average period of 3.5 years (32–48 months) at regular intervals. Functional outcome and complications if any, were recorded at every follow-up. Results: At final follow-up, the mean range of motion of wrist with 42.1° ± 5.9° of flexion, 72.9° ± 6.4° of extension, 82.1° ± 8.1° of supination and 85.0° ± 5.8° of pronation was achieved. The mean visual analog scale score at the final follow-up was 0.9 ± 0.9. The mean modified Mayo wrist score was 71.4 ± 6.4 with a mean modified Musculoskeletal Tumor Society score of 25.9 ± 0.8 and a mean Disability of Arm, Shoulder, and Hand score of 17.9 ± 1.6 at the final follow-up. The average time for the radiological union of iliac crest graft with the distal end radius was 13.3 weeks. None of the patient reported any complication or recurrence. Conclusion: The reconstruction of distal radioulnar joint by fixation of tricortical iliac crest graft with distal end radius and stabilization of ulnar stump by extensor capi ulnaris tenodesis after the wide resection of distal ulna giant cell tumor is recommended for good to excellent functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical and functional outcomes of reconstruction following en bloc resection for the Campanacci grade III distal ulnar giant cell tumors

Kumar

Rustagi

Talwar

et al. 2022

Journal of Orthopaedics, Trauma and Rehabilitation

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“…9 13 17 In three studies, prosthetic reconstruction with implant arthroplasty of the distal radioulnar joint was reported, [14][15][16] while reconstruction of the distal radioulnar joint using an iliac bone block and screws-a modification of the Sauvé-Kapandji procedure-was reported in two studies. [18][19][20] Ferguson et al 13 and Papanastassiou et al 9 reported that reconstruction was not essential based on case comparisons of their own studies. In fact, in more than half of the reviewed cases, no reconstruction was performed, and almost all obtained favourable results (average Musculoskeletal Tumor Society scoring system score: 88.7%, range 30%-100%).…”

Section: Discussionmentioning

confidence: 99%

Recurrent giant cell tumour of the distal ulna after en bloc resection with preoperative denosumab use

et al. 2021

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In recent years, denosumab has been used to treat giant cell tumour of bone (GCTB) not only in cases where surgery is complicated but also preoperatively to decrease the preoperative grade or to facilitate surgery for Campanacci grade II and III cases. However, there are no clear protocols regarding the preoperative use of denosumab before en bloc resection. There are a few reports of recurrent cases after en bloc resection; however, the association with the use of denosumab is unknown. We present the clinical, radiological and histopathological findings of a case of Campanacci grade III GCTB at the distal end of the ulna, which resulted in soft tissue recurrence after en bloc resection with the preoperative use of denosumab.

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A Comparison of Outcomes of ‘Extensor Carpi Ulnaris Tenodesis’ versus ‘No Tenodesis’ after Resection of the Distal Ulna in Patients with Giant Cell Tumor

Sahito

Ali

QAMAR

et al. 2022

J Hand Surg Asian-Pac Vol

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Background: One of the methods of stabilizing the stump of the ulna following resection of the distal ulna is tenodesis of the extensor carpi ulnaris (ECU). Some studies have recommended stabilization, whereas others have not found it useful. Most of these studies have a mix of different pathologies and often do not have a control group. The aim of this study is to compare the outcomes of ECU tenodesis versus no tenodesis after resection of the distal ulna in patients with grade III giant cell tumor (GCT) of the distal ulna. Methods: The retrospective study included 10 patients with Campanacci grade III GCT of the distal ulna treated by resection of the distal ulna between 2014 and 2019. Patients were stratified into two groups based on whether they underwent ECU tenodesis (n = 5) or no tenodesis (n = 5). The patients were assessed at 6 weeks, 6 months, and 12 months for complications and outcomes using the Mayo wrist score (MWS) and the revised musculoskeletal tumor society score (MSTS). Results: The MWS and the MSTS were significantly better in the ECU tenodesis group at 6 weeks. At 6 months, MWS was similar in both groups, but MSTS continued to be significantly better in ECU tenodesis group. At 12 months, both groups reported similar MWS and MSTS. There were no recurrences in either groups. One patient in the ECU tenodesis group developed ECU tendonitis that resolved with conservative treatment. Conclusions: The outcomes of ECU tenodesis were better in the short term (6 months), although both groups reported similar outcomes at 12 months. Level of Evidence: Level III (Therapeutic)

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Modified Sauve-Kapandji Procedure Using Iliac Bone Graft for Giant Cell Tumor of the Distal Ulna: Stabilizing With Two-Screw Fixation

Cited by 3 publications

References 14 publications

Clinical and functional outcomes of reconstruction following en bloc resection for the Campanacci grade III distal ulnar giant cell tumors

Clinical and functional outcomes of reconstruction following en bloc resection for the Campanacci grade III distal ulnar giant cell tumors

Recurrent giant cell tumour of the distal ulna after en bloc resection with preoperative denosumab use

A Comparison of Outcomes of ‘Extensor Carpi Ulnaris Tenodesis’ versus ‘No Tenodesis’ after Resection of the Distal Ulna in Patients with Giant Cell Tumor

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