Partial wrist arthrodesis versus arthroplasty for distal radius giant cell tumours

Abstract

Purpose The purpose of this study was to evaluate the clinical efficacy of using the proximal fibular graft for partial wrist arthrodesis or arthroplasty after the resection of giant cell tumours of the distal radius. Methods Between February 2006 and August 2010, 14 patients (seven males, seven females; average age, 35.7 years) with grade II and III giant cell tumours of the distal radius were treated by tumour resection and autologous proximal fibular grafts to reconstruct the wrist in our hospital. Seven patients each were treated by wrist arthroplasty and partial wrist arthrodesis, and were followed up for 2.2-6.8 years (average, 3.9 years).

Clinical and Radiographic Results of Reconstruction with Fibular Autograft for Distal Radius Giant Cell Tumor

“…Many techniques have been used to reconstruct the defects, including vascularized/non‐vascularized fibular grafts, osteoarticular allografts, partial/total wrist arthrodesis and custom‐made prostheses. Each technique has its own unique possible advantages and disadvantages, which has been thoroughly discussed and debated .…”

“…En bloc resection of the distal radius must be followed by meticulous reconstruction of the bone defect to preserve the wrist function and alignment. Many techniques have been used to reconstruct the defects, including vascularized 27 /non-vascularized fibular grafts 28,29 , osteoarticular allografts 30 , partial/total wrist arthrodesis and custom-made prostheses 8,10,11,14,16,[28][29][30][31][32] . Each technique has its own unique possible advantages and disadvantages, which has been thoroughly discussed and debated 11,20,27,28,30,[32][33][34] .…”

“…Reconstruction with a non‐vascularized proximal fibular autograft is therefore widely performed. To date, there have been a number of single institution studies on the outcomes of reconstruction with fibular autografts. However, to the best of our knowledge, there are no multicenter studies on this subject from China.…”

Successful joint preservation of distal radius osteosarcoma by en bloc tumor excision and reconstruction using a tumor bearing frozen autograft: a case report

“…However, this may come at the expense of wrist stability when compared to wrist arthrodesis. Zhu et al compared the functional outcomes of 14 distal radius giant cell tumors treated by partial wrist arthrodesis using fibular grafts or arthroplasty using fibular head grafts and found that there were significant differences in flexion-extension; the average wrist ROM of the 7 patients that underwent partial arthrodesis were 55.9° of total flexion-extension and 127.6° of total pronation-supination, whereas the average wrist ROM of the 7 patients that underwent wrist arthroplasty were 71.6° of total flexion-extension and 140° of total pronation-supination [ 16 ].…”

Functional outcome of en bloc resection of a giant cell tumour of the distal radius and arthrodesis of the wrist and distal ulna using an ipsilateral double barrel segmental ulna bone graft combined with a modified Sauve-Kapandji procedure

“…The prime objective is cure; the secondary objective is the preservation of as much function as possible. A number of techniques have been used for reconstruction, such as a wrist arthrodesis or arthroplasty with an allograft, a vascularized or non-vascularized fibular autograft, ulnar translocation or a custom-made wrist prosthesis (Duan et al, 2013; Peng-Fei and Yu-Hua, 2011; Saikia et al, 2010; Zhu et al, 2013). Although the outcomes of these reconstructions are promising, complications have been described.…”