title: Reconstruction of the distal radius with non-vascularised fibular graft after resection of giant cell tumour of bone.
abstract: OBJECTIVE
  To evaluate outcomes of wide resection and reconstruction of the distal radius with non-vascularised autogenous fibular grafts for giant cell tumour (GCT) of bone.
  
  
  METHODS
  Medical records of 7 men and 5 women aged 22 to 47 (mean, 31) years who underwent wide resection of the distal radius and reconstruction with non-vascularised autogenous fibular grafts for GCT of bone were reviewed. The mean length of the resected radius was 9 (range, 7-11) cm. The ipsilateral proximal fibula with a small portion of attached ligament was harvested. The articular surface of the graft was fixed to the scapholunate articular surface by Kirschner wires, and the ligament of the fibular head was sutured to the carpal ligaments. The graft was fixed to the proximal radius with a small dynamic compression plate. Iliac cancellous bone graft was added. Pain, instability, and functional status were assessed. Wrist joint movements were measured using a goniometer. The grip strength was measured. The operated and contralateral sides were compared.
  
  
  RESULTS
  The mean follow-up was 24 (range, 20-27) months. All patients achieved radiological union after a mean of 16 (range, 14-20) weeks. The mean active range of movement in the operated wrists was 32º dorsiflexion, 38º palmar flexion, 15º radial deviations, 12º ulnar deviations, 50º supination, and 60º pronation. Compared with the contralateral wrists, the operated wrists regained 60% of the function, with satisfactory grip strength, and normal finger and thumb movements and hand sensation. No patient had recurrence after 2 years. Two patients had minor dorsal subluxation, which was resolved with a wrist brace. Three patients had superficial infection, which was resolved with intravenous antibiotics and dressings. Two patients had peroneal nerve palsy, which recovered completely in 12 weeks.
  
  
  CONCLUSIONS
  Non-vascularised fibular grafts for reconstruction of the distal radius after resection of a GCT of bone achieved good cosmetic and functional outcomes.
authors.affiliation: Dow University of Health Sciences/Civil Hospital Karachi, Karachi, Pakistan.
authors.forename: Syed Mujahid
authors.initials: SM
authors.lastname: Humail
authors.forename: Mustaff K K
authors.initials: MK
authors.lastname: Ghulam
authors.forename: Itaat Hussain
authors.initials: IH
authors.lastname: Zaidi
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D005260:Female; D005360:Fibula / Q000637:transplantation*; D018212:Giant Cell Tumor of Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000601:surgery*; D019651:Plastic Surgery Procedures; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: autografts; fibula; giant cell tumor of bone; radius