The use of osteo-articular allografts for reconstruction after resection of the distal radius for tumour.
Several techniques have been described to reconstruct a mobile wrist joint after resection of the distal radius for tumour. We reviewed our experience of using an osteo-articular allograft to do this in 17 patients with a mean follow-up of 58.9 months (28 to 119). The mean range of movement at the wrist was 56° flexion, 58° extension, 84° supination and 80° pronation. The mean ISOLS-MSTS score was 86% (63% to 97%) and the mean patient-rated wrist evaluation score was 16.5 (3 to 34). There was no local recurrence or distant metastases. The procedure failed in one patient with a fracture of the graft and an arthrodesis was finally required. Union was achieved at the host-graft interface in all except two cases. No patient reported more than modest non-disabling pain and six reported no pain at all. Radiographs showed early degenerative changes at the radiocarpal joint in every patient. A functional pain-free wrist can be restored with an osteo-articular allograft after resection of the distal radius for bone tumour, thereby avoiding the donor site morbidity associated with an autograft. These results may deteriorate with time.
AOU Careggi, Orthopedic Oncology Unit, Largo Palagi 1, Firenze 50139, Italy. guido.scoccianti@alice.it
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Scoccianti
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Campanacci
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Beltrami
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Caldora
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Capanna
D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*