title: Vascularized fibular graft for reconstruction of the wrist after excision of giant cell tumor.
abstract: Seven patients with a giant-cell tumor involving the distal end of the radius were treated with en bloc resection and reconstruction with a free vascularized fibular graft. Two patients with stage 2 disease of Enneking's surgical staging and grade 2 of Campanacci's radiographic grading system were reconstructed with an articular fibular head graft. Five patients with stage 3 and grade 3 disease underwent wrist arthrodesis using fibular shaft transfer. There was radiographic evidence of bone union at the host-graft junctions in all cases. No local recurrence was seen in any of the patients at the most recent follow-up examinations. There were six good and one excellent functional results. Wrist arthroplasty using a vascularized fibula head graft is the best procedure for a stage 2 or grade 2 giant-cell tumor of the distal end of the radius. In cases of stage 3 or grade 3 disease, wrist arthrodesis using a vascularized fibular shaft graft is indicated.
authors.affiliation: Department of Orthopaedic Surgery, Nara Medical University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ono
authors.forename: H
authors.initials: H
authors.lastname: Yajima
authors.forename: S
authors.initials: S
authors.lastname: Mizumoto
authors.forename: Y
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Y
authors.initials: Y
authors.lastname: Mii
authors.forename: S
authors.initials: S
authors.lastname: Tamai
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011884:Radius; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*