| Treatment of Giant Cell Tumor Involving Distal Radius |
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Chung Soo Han, Duke Hwan Chung, Young Ho Lee, Seung Hwan Kim |
| 요골 원위부 전체를 침범한 거대세포종의 치료 |
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한정수, 정덕환, 이영호, 김승환 |
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| Abstract |
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Introduction : In this report, we will report the clinical results, functional evaluation and complication after surgical treatment of giant cell tumor involving distal radius. Materials and Methods : We have reviewed 9 cases. They were 38 years old on average and the average follow up period was 3 years and 11 months. Eight were initial lesion while the other one was local recurrence. As a method of treatment, intralesional curettage with cement filling were performed for treatment of one initial lesion, and wide resection and wrist reconstruction for treatment of eight cases including recurred lesion. Among those eight cases, ulnar transposition together with wrist arthrodesis were performed for one patient, and vascularized fibula graft for seven. We have followed up, both clinically and radiologically, recurrence of tumor and complications of all the patients, and measured pain, range of motion, grasping power as a evaluation of function. Results : None of the 9 cases showed evidences of local recurrence. In one case of intralesional curettage with cement filling, there was no postoperative pain, and a joint moved to the normal range of motion. In the other one case of ulnar transposition with wrist arthrodesis, there is no postoperative pain either, but wrist had become ankylosed. In one of the seven cases of vascularized fibula graft, volar subluxation of wrist developed and wrist arthrodesis was performed. It took 3 months on average for grafted bone union, and complications such as nonunion or fracture did not occurred. Range of motion averaged 25¡Æ in flexion, 36¡Æ in extension, and 14¡Æ in radial deviation, 15¡Æ in ulnar deviation and grasping power of 4 patients averaged 90% of normal. Conclusion : The advantages of reconstruction using vascularized fibula graft also include maintenance of wrist function and rapid recovery of large bone defect. However, long operating hours, difficult operative technique including fibular harvest and possible complications such as subluxation and nonunion are disadvantages. Therefore, it should be essential for rehabilitation and prevention of recurrence to choose proper surgical methods according to various cases. |
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