Tumeur à cellules géantes de la phalange proximale du pouce : résection–autogreffe iliaque et arthrodèse bipolaire

Fnini, S.; Labsaili, N.; Messoudi, A.; Largab, A.

doi:10.1016/j.main.2007.10.007

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…The presented patient had a restoration of her thumb stability and movement after reconstruction of the first metacarpal with a free vascularized fibula combined with a CMC-1 joint prosthesis after wide GCT resection. Benign GCTs have a high risk of recurrence 3,4 when the bone is destroyed and soft tissues are involved. Therefore, wide resection is important in these cases to minimize recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

“…If joints are affected, one therapeutic option is joint arthrodesis that is frequently performed in finger joints. 4,12 However, the patient was left-handed, and the loss of function in CMC-1 arthrodesis is significant. 38 Furthermore, nonvascularized bone reconstruction of large defects of the first metacarpal in combination with an arthrodesis risk a nonhealing of the fusion, restricted range of motion, and loss of grip strength.…”

Section: Discussionmentioning

confidence: 99%

“…1 Although osseous GCTs account for approximately 5% of bone tumors, only 2% to 5% of GCTs occur in the hand. [2][3][4] Soft tissue extension of the tumor increases the risk of local recurrence. 5 Approximately 1% to 9% of GCT cases were reported to metastasize to the lungs.…”

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confidence: 99%

“…The tumor consists of mononuclear stromal cells and multinuclear osteoclast-like giant cells, with receptor activator of nuclear factor κB ligand (RANKL)–expressing stromal cells caused by a single-point mutation at histone H3.3 (H3F3A) in stromal cells 1 . Although osseous GCTs account for approximately 5% of bone tumors, only 2% to 5% of GCTs occur in the hand 2–4 . Soft tissue extension of the tumor increases the risk of local recurrence 5 .…”

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confidence: 99%

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Conjoined Free Fibula Transplantation and First Carpometacarpal Joint Prosthesis for Functional Thumb Reconstruction—A Case Report

Rein,

Geister,

Kremer

2023

Ann Plast Surg

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Background Giant cell tumors grow locally invasive with osseous and soft tissue destruction, requiring wide resection to avoid recurrence. Stable reconstruction of the first carpometacarpal (CMC-1) joint remains a challenge due to its high range of mobility. The latter is of paramount for the functionality of the hand. Purpose Therefore, the aim of this study was to report our approach for a combined reconstruction of the first metacarpal and the CMC-1 joint. Methods A 58-year-old woman underwent wide resection of a benign giant cell tumor at the base and shaft of the first metacarpal of the left thumb. Because of the loss of the CMC-1 joint and the instability of the thumb, an osseous reconstruction using a vascularized fibular graft combined with a TOUCH Dual Mobility CMC-1 prosthesis was performed to reconstruct the CMC-1 joint. Results Osseous healing was observed after 3 months. No tumor recurrence and good joint function were documented at the follow-up investigation after 1 year. The patient reported only minor restrictions during activities of daily living. Thumb opposition was possible with a Kapandji score of 8/10. A slight pain while walking remained as a donor-side morbidity at the right lower leg. Conclusion Metacarpal reconstruction with vascularized fibula bone grafts allowed a combined joint reconstruction with a commercially available prosthesis, which is an approach to restore the complex range of motion of the thumb.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Conjoined Free Fibula Transplantation and First Carpometacarpal Joint Prosthesis for Functional Thumb Reconstruction—A Case Report

Rein,

Geister,

Kremer

2023

Ann Plast Surg

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“…In this case, retaining function of the thumb with sufficiently aggressive surgical treatment is extremely difficult. 5 The treatment of GCT using intraregional procedures includes the following: curettage and bone grafting or excisional procedures, such as local excision, wide excision, amputation, and ray resection. 1 Intralesional curettage may be improved with local adjuvant treatment, such as phenol, 6 , 7 alcohol, 8 , 9 and cryotherapy.…”

Section: Discussionmentioning

confidence: 99%

The giant cell tumour of the proximal phalanx of the thumb treated by a 2-stage operation

Reichert

Gosk

2017

Acta Orthopaedica et Traumatologica Turcica

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We present a 29-year-old woman who was treated for a giant-cell tumour of her thumb. Surgical treatment was performed in two stages. In the first stage, the tumour was removed and the first metacarpal and distal phalanges were fixed by an external fixator. In the second stage of reconstruction of the thumb, a cortico-cancellous bone graft from the iliac crest, an external fixator and double arthrodesis were used. This two-stage procedure provides the possibility for confirming the diagnosis and appropriate treatment choice and minimizes the risk of recurrence.

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Autologous structural iliac bone grafts in reconstructions of short bone defects in the hand and foot after primary bone tumor resections: a single-institution retrospective study

Lesenský

Němec

Kofránek

et al. 2017

Eur J Orthop Surg Traumatol

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The use of structural autografts from the iliac crest for reconstruction of bony defects in the hand and foot was described by Wilson and Lance in 1965. However, very few series of this technique are published and long-term results are unknown. We present a single-institution series of 23 patients with a mean follow-up of 92 months. We also describe a novel modification of this technique using the anterior superior iliac spine for reconstruction of the adjacent joint. Failure rate was 13% at mean of 17.3 months. All patients had a firm grip in the hand and walked without support. Bony fusion was achieved in all cases regardless of the type of fixation used. The use of ASIS for joint reconstruction was successful, particularly in low-demand joints. We encountered 1 case of instability and progressive stiffness in weight-bearing joints. This is a reliable method of reconstructing bony defects in the hand or foot following tumor resections.

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Tumeur à cellules géantes de la phalange proximale du pouce : résection–autogreffe iliaque et arthrodèse bipolaire

Cited by 6 publications

References 23 publications

Conjoined Free Fibula Transplantation and First Carpometacarpal Joint Prosthesis for Functional Thumb Reconstruction—A Case Report

Conjoined Free Fibula Transplantation and First Carpometacarpal Joint Prosthesis for Functional Thumb Reconstruction—A Case Report

The giant cell tumour of the proximal phalanx of the thumb treated by a 2-stage operation

Autologous structural iliac bone grafts in reconstructions of short bone defects in the hand and foot after primary bone tumor resections: a single-institution retrospective study

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