title: Distal radius reconstruction with vascularized proximal fibular autograft after en-bloc resection of recurrent giant cell tumor.
abstract: Giant cell tumors (GCTs) located in the distal radius are likely to recur, and the treatment of such recurrent tumors is very difficult. Here, we report our clinical experience in distal radius reconstruction with vascularized proximal fibular autografts after en-bloc excision of the entire distal radius in 17 patients with recurrent GCT (RGCT) of the distal radius.
  
  
  
  All 17 patients with RGCT in distal radius underwent plain radiography and/or magnetic resonance imaging (MRI) of the distal radius as the initial evaluation after hospitalization. Then the distal radius were replaced by vascularized proximal fibular autografts after en-bloc RGCT resection. We assessed all patients by using clinical examinations, plain radiography of the wrist and chest, and Mayo wrist scores in the follow-ups.
  
  
  
  After an average follow-up of 4.3 years (range: 1.5-10.0 years), no lung metastasis or local recurrence was detected in any of the 17 patients. In total, 14 patients had excellent or good functional wrist scores, 16 were pain free or had occasional pain, and 15 patients returned to work. The mean range of motion of the wrist was 101° (flexion-extension), and the mean grip strength was 77.2 % of the contralateral normal hand.
  
  
  
  En-bloc excision of the entire distal radius and distal radius reconstruction with a vascularized proximal fibular autograft can effectively achieve local tumor control and preserve wrist function in patients with RGCT of the distal radius.
authors.affiliation: Division of Orthopaedic Trauma and Hand Surgery, Department of Orthopaedic Surgery, Guangzhou First people's Hospital, Guangzhou Medical University, 1 Panfu Road, Guangzhou, Guangdong, 510180, People's Republic of China. yangyunfa@gzhmu.edu.cn.
authors.forename: Yun-Fa
authors.identifier: 0000-0003-3722-326X
authors.initials: YF
authors.lastname: Yang
authors.affiliation: Division of Orthopaedic Trauma and Hand Surgery, Department of Orthopaedic Surgery, Guangzhou First people's Hospital, Guangzhou Medical University, 1 Panfu Road, Guangzhou, Guangdong, 510180, People's Republic of China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Liwang Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510170, People's Republic of China.
authors.forename: Pin
authors.initials: P
authors.lastname: Huang
authors.affiliation: Division of Orthopaedic Trauma and Hand Surgery, Department of Orthopaedic Surgery, Guangzhou First people's Hospital, Guangzhou Medical University, 1 Panfu Road, Guangzhou, Guangdong, 510180, People's Republic of China.
authors.forename: Zhong-He
authors.initials: ZH
authors.lastname: Xu
mesh_terms: D000328:Adult; D064592:Autografts / Q000098:blood supply; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011859:Radiography; D011884:Radius / Q000473:pathology* / Q000601:surgery; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome; D014953:Wrist / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Distal radius reconstruction; En-bloc resection; Recurrent giant cell tumor; Vascularized proximal fibular graft