Nonvascularized proximal fibular autograft to treat giant-cell tumor of the distal radius.
BACKGROUND
The Distal end of the radius is the third most common site where giant-cell tumors occur. High recurrent rate was reported after curettage. To manage such aggressive tumors, wide resection is the best treatment and nonvascularized proximal fibular autograft has been widely used for reconstruction.


METHODS
Eight patients were treated here with this method from April, 1988 to April, 1992. Patients' average age was 40 years, and all had grade III. Of the four males and females, six tumors were over the dominant hands and the other two, over the nondominant ones. They were treated primarily with wide resection and reconstruction with osteochondral proximal fibular autograft, from either the ipsilateral or contralateral side. Bone anastomotic site was fixed with dynamic compression plate. The soft tissue was directly repaired in six patients and reinforced with extensor carpi radialis longus tendon in two.


RESULTS
Patients were regularly followed from 14-60 months, for an average of 25 months. The average grip strength of the affected hands was 77% that of the unaffected sides. There were four distal radioulnar joint diastasis, one ulnar deviation of the wrist, one volar tilt of the carpal bones and one transient peroneal palsy over the donor site. No recurrence or metastasis was found up to the last follow-up. The average total range of motion of the affected wrist (supination, pronation, dorsiflexion and palmar flexion) was 185 degrees. All Patients were satisfied with the results.


CONCLUSIONS
Using proximal fibular autograft to reconstruct the bony defect and joint after wide excision for distal radial giant-cell tumor gives satisfactory results. It is a widely accepted good method, though there are many problems still unresolved.
Chiang
I M
IM
Department of Orthopedics and Traumatology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Chen
T H
TH
Shih
L Y
LY
Lo
W H
WH
D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D018212:Giant Cell Tumor of Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011884:Radius; D014182:Transplantation, Autologous