VASCULARIZED FIBULAR GRAFT FOR RECONSTRUCTION OF THE WRIST AFTER EXCISION OF GIANT-CELL TUMOR

Seven patients with a giant-cell tumor involving the distal end of the radius were treated with en bloc resection and reconstruction with a free vascularized fibular graft. Two patients with stage 2 disease of Enneking's surgical staging and grade 2 of Campanacci's radiographic g rading system were reconstructed with an articular fibular head graft. Five patients with stage 3 and grade 3 disease underwent wrist arthro desis using fibular shaft transfer. There was radiographic evidence of bone union at the host-graft junctions in all cases. No local recurre nce was seen in any of the patients at the most recent follow-up exami nations. There were six good and one excellent functional results. Wri st arthroplasty using a vascularized fibula head graft is the best pro cedure for a stage 2 or grade 2 giant-cell tumor of the distal end of the radius. In cases of stage 3 or grade 3 disease, wrist arthrodesis using a vascularized fibular shaft graft is indicated.