Wide resection and stabilization of ulnar stump by extensor carpi ulnaris for giant cell tumor of distal ulna: two case reports

Abstract

The distal end of ulna is an extremely uncommon site for primary bone tumors in general and giant cell tumor in particular. Wide resection is usually indicated in such cases and at times it may be necessary to remove of a long segment of the distal ulna. Any ulnar resection proximal to the insertion of pronator quadratus can lead to instability in the form of radio-ulnar convergence and dorsal displacement (winging) of the ulnar stump. This can result in diminution of forearm rotation and weakness with grasp. Stabilization of the ulnar stump after resection for a giant cell tumor was described by Kayias & Drosos. We are adding two more cases to the literature. Both patients had excellent functional outcome and there were no instances of recurrence at three years of follow-up.

Giant Cell Tumour of the Distal Ulna: A Case Report

“…According to Schajowicz [11] , curettage alone is an inadequate oncological procedure, but when it is combined with an adjuvant therapy, it globally provides a better result with respect to one-block excision, especially in terms of functionality. Therefore, the correct treatment must achieve a balance between oncological radicality and the restoration of skeletal segment functionality [12][13][14] . Curettage associated with bone grafting has been shown to be effective in many cases [15] .…”

A rare case of distal ulna giant cell tumour – Wide excision and stabilisation using extensor carpi ulnaris tendon

“…Long term complications have been reported in the form of gradually progressive ulnar translocation of carpals and subsequent wrist arthritis. Various reconstructive procedure have been used by various authors including vascularized fibular graft , distal radio-ulnar joint metallic prosthesis [6,7,8,9], palmaris longus graft for ulnar stabilization, static as well as dynamic stabilization of ulna using extensor carpi ulnaris split tendon graft [10]. Using extensor carpi ulnaris tendon for ulnar stabilization was described by Goldner and Hayes.…”

Ulnar buttress arthroplasty after enbloc resection of a giant cell tumor of the distal ulna

“…Because of its aggressive nature and high chances of recurrence, enbloc resection is recommended for a GCT of the distal ulna 2. The loss of ulnar support causing ulnar translation of carpal bones and ulnar stump instability are the major concerns after resection of the distal ulna 1–4. A satisfactory functional outcome has been reported after the placement of a distal radioulnar prosthesis 5.…”