Giant Cell Tumour Distal Radius in Patient with Functional Outcome after Reconstruction by En-Bloc Resection and Non-Vascularized Fibular Bone Graft: A Case Report

Author(s): Md. Jillur Hasan, Md. Rezaul Karim, Md. Hasibuzzaman, Maruf Munsur

Giant cell tumour of the distal radius is the 3rd most common site after proximal tibia and distal femur. It is locally aggressive and is associated with a high rate of recurrence. Although it is usually treated with various modalities of treatment, wide resection and reconstruction with proximal fibular autograft is most commonly accepted in recurrent cases. The following is a case report of such a case with surgical management. A 22-year-old female patient complaining of pain and lump in left wrist since two years ago. The pain worsened since 1 month before consultation, but did not radiate elsewhere. Pain was aggravated by movement and relieved with rest. Physical examination revealed a 3 cm mass with tenderness over left wrist and lump size 2.5 cm, no venectasis, no shiny skin and no deformity. With clinical suspicion of benign bone tumor on left wrist, further evaluation was needed. Plain radiograph revealed an expansile, lytic lesion and soap bubble appearance on her left distal radius like a GCT. Open biopsy result revealed similar morphology with GCT. Reconstruction by en-bloc surgical excision, followed with non-vascularized fibular bone graft fixed with dynamic compression plate (DCP) and wrist ligament reconstruction and fixation of the head of the fibula with carpal bones and distal end of the ulna using K-wires along with palmaris longus tendon were performed. Reconstruction with non- vascularized fibular graft, internal fixation with DCP with trans fixation of the fibular head and wrist ligament reconstruction minimizes the problem and gives satisfactory functional results.

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