[Giant cell tumor at the wrist: a review of 23 cases].
OBJECTIVE
We evaluated patients who underwent surgical treatment for giant cell tumor of the wrist with regard to recurrence rates, factors influencing tumor recurrence, complications, and postoperative functional and emotional status of the patients.


METHODS
The study included 23 patients (6 males, 17 females; mean age 31.6 years; range 12 to 74 years) who were treated surgically for giant cell tumor of the wrist. Grading, assessment of surgical margins, and functional evaluation were performed according to the Enneking's criteria. The effects of tumor volume, soft tissue extension, and selected surgical therapy on recurrence were investigated. Joint movements and stability, postoperative pain, presence of deformity, muscle strength, limitations in functional activities, and patient satisfaction were evaluated. The mean follow-up period was 6.7 years.


RESULTS
Of all the patients, 69% had stage 2 and 23% had stage 3 tumors. There was no significant correlation between tumor volume and recurrence (p=0.22). Recurrences were observed in three (33%) of nine patients with soft tissue extension and in four (28.6%) of 14 patients without soft tissue extension. Recurrence rates were 33.3% in those who were treated by curettage alone (n=3), 50% with curettage and grafting (n=6), 50% with curettage and bone cement (n=2), and 16% in those who underwent wide excision (n=12).


CONCLUSIONS
The most important factor influencing recurrence rate in giant cell tumors is the extent of surgical resection. At least marginal resection must be considered in patients with stage 2 and 3 lesions especially in cases with soft tissue extension. Adjunctive therapy should be added if curettage is considered.
Ozalp
Taçkin
T
Celal Bayar Universitesi Tip Fakültesi Ortopedi ve Travmatoloji Anabilim Dali. tackino@yahoo.fr
Yercan
Hüseyin
H
Okçu
Güvenir
G
Ozdemir
Oğuz
O
Coşkunol
Erhan
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D002648:Child; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D009367:Neoplasm Staging; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D016896:Treatment Outcome; D014953:Wrist / Q000473:pathology*