Functional outcome of en bloc excision and osteoarticular allograft replacement with the Sauve-Kapandji procedure for Campanacci grade 3 giant-cell tumor of the distal radius.
OBJECTIVE
Multiple options have been reported for reconstruction of Campanacci grade 3 giant-cell tumor of the distal radius after resection. In 1990, the senior author described an allograft reconstruction combined with a Sauve-Kapandji procedure after distal radius resection and reported preliminary results in 3 patients. The purpose of this study was to assess with validated patient outcome surveys the intermediate to long-term outcomes of all patients treated with this surgery and to analyze their functional results and document tumor control.


METHODS
All cases of distal radius osteoarticular allograft combined with the Sauve-Kapandji reconstruction for Campanacci grade 3 giant-cell tumors performed from 1986 to 2000 by a single surgeon were evaluated by clinical and radiologic examinations; the Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form-36; and Mayo Wrist scores.


RESULTS
Nine consecutive patients (7 women, 2 men) with an average age at follow-up evaluation of 42 years and with a Campanacci grade 3 giant-cell tumor of the distal radius formed the study population. Clinical follow-up time after reconstruction averaged 7 years. Examination showed an average of 51 degrees of extension and 19 degrees of flexion of the wrist and 63 degrees of supination and 79 degrees of pronation of the forearm. Grip strength measured in 5 patients averaged 23 kg. The Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form-36; and the Mayo Wrist scores averaged 15, 72, and 73, respectively. These scores indicate modest functional impact. No patient had tumor recurrence, metastases, nonunion, or proximal ulna instability.


CONCLUSIONS
En bloc resection of a Campanacci grade 3 giant-cell tumor of the distal radius followed by reconstruction with an osteoarticular allograft and a Sauve-Kapandji procedure with autogenous bone graft results in a reasonable functional outcome at intermediate to long-term follow-up evaluation.


METHODS
Therapeutic IV.
Szabo
Robert M
RM
Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, Sacramento, 95817, USA. rmszabo@ucdavis.edu
Anderson
Kurt A
KA
Chen
James L
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000379:methods*; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000473:pathology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D007085:Ilium / Q000637:transplantation; D007593:Joint Instability / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011884:Radius / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery