title: Clinical and Radiographic Results of Reconstruction with Fibular Autograft for Distal Radius Giant Cell Tumor.
abstract: OBJECTIVE
  To evaluate the result of en bloc resection and reconstruction of the distal radius with a non-vascularized fibular autograft for giant cell tumor (GCT) of bone.
  
  
  METHODS
  Between 2005 and 2015, 12 eligible patients (seven males, five females, mean age 31.3 years) with grade III GCT of the distal radius were treated by en bloc resection and reconstruction with non-vascularized proximal fibular autografts in four Chinese institutions (members of Giant Cell Tumor Team of China). The patients had a clinical and radiographic review every 6 months for the first 2 years then annually thereafter. The functional, oncologic and radiological outcomes of the patients were analyzed.
  
  
  RESULTS
  The mean duration of follow-up was 39.6 months. Bony union was achieved in all cases. None of the patients were dissatisfied with the shape and appearance of the wrist. The mean MSTS score was 25.23 ± 2.38 (range, 22-29). The mean DASH score was 13.0 (range, 6.7-33.3). The average range of motion of the wrist was: 35.8° ± 14.5° of extension, 14.0° ± 8.4° of flexion, 15.5° ± 6.7° of radial deviation, 19.4° ± 10.1° of ulnar deviation, 57.2° ±18.9° of pronation and 44.0° ± 24.8° of supination. The average percentage of grip strength was 55.2% ± 29.0% compared with that of the contralateral side. One localized soft tissue recurrence occurred; it was successfully managed by excision. Lung metastases developed postoperatively in one case and were treated by gamma knife radiotherapy. There was radiographic evidence of radiocarpal arthritis in eleven patients, bone resorption in ten, distal radioulnar joint diastasis in six, ulnar deviation of the wrist in seven, subluxation of the carpal bone in three and dislocation of the carpal bone in one patient.
  
  
  CONCLUSIONS
  Reconstruction with a non-vascularized proximal fibular autograft is a reasonable option after en bloc resection of the distal radius for giant cell tumor of bone.
authors.affiliation: Department of Musculoskeletal Tumor, Key Biomechanical Laboratory of Orthopaedics, Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Dian-Wen
authors.initials: DW
authors.lastname: Qi
authors.affiliation: Graduate School, Hebei Medical University, Tianjin, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Zhejiang University, Hangzhou, China.
authors.forename: Zhao-Ming
authors.initials: ZM
authors.lastname: Ye
authors.affiliation: Department of Orthopaedics, General Hospital of Jinan Military Region, Jinan, China.
authors.forename: Xiu-Chun
authors.initials: XC
authors.lastname: Yu
authors.affiliation: Department of Bone Oncology, Tianjin Hospital, Tianjin, China.
authors.forename: Yong-Cheng
authors.initials: YC
authors.lastname: Hu
authors.affiliation: Department of Musculoskeletal Tumor, Key Biomechanical Laboratory of Orthopaedics, Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Guo-Chuan
authors.initials: GC
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Zhejiang University, Hangzhou, China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Yan
authors.affiliation: Department of Orthopaedics, General Hospital of Jinan Military Region, Jinan, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zheng
authors.affiliation: Graduate School, Tianjin Medical University, Tianjin, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Zhao
authors.affiliation: Graduate School, Tianjin Medical University, Tianjin, China.
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D064592:Autografts; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography / Q000379:methods*; D011884:Radius; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Distal radius; En-bloc resection; Giant cell tumor; Non-vascularized fibular autograft