Resection and reconstruction of distal radius Giant cell tumour using avascular autogenous fibular graft

Abstract : We report a case series of four patients with giant cell tumour of the distal end of the radius managed by wide resection and reconstruction using fibular autograft and its oncological and functional outcome from January 2009 and July 2011.There were 4 cases of GCT involving distal radius managed by wide resection and autogenous fibular bone grafting with a mean age of 21 years. All patients were Campanacci Grade III . The mean follow up was 16.25 months with a maximum follow up of 26 months. The functional and oncological outcomes of the patients were analysed. The functional outcome of the patients were evaluated using the Musculoskeletal tumour society scoring the mean of which was 22(range 18 to 26). . Three patients showed clinical and radiological union. Average palmar flexion of the wrist was 67 degrees (range 55 to 85) and dorsiflesion was 50 degrees (range 20 to 70). The mean supination achieved in our study was 31 degrees(range 0-50) and the mean pronation was 75 degrees( range 60-90). None of our patients had a recurrence at the surgical site or distant metastasis at the time of latest follow-up. Stiffness was reported in all the patients in our study which was seen in most other studies. The results we have are comparable to other studies done with larger sample size. Reconstruction of the distal radius with avascular autogenous fibular graft after resection for a Grade III Campanacci Giant cell tumor of the distal radius provides adequate functional restoration of the wrist with excellent oncological outcome.