Vascularized fibular graft after excision of giant cell tumor of the distal radius - A case report

Although hemiarthroplasty of the wrist using vascularized proximal fibula h as been described often, long term results with documentation of results ar e insufficient. A case of giant cell tumor of the distal radius with remark able extraskeletal extension is reported, Vascularized fibula including its proximal head was used to replace the defect created after en bloc resecti on of the tumor, There was no deterioration in radiographic findings or fun ction of the new joint at the time of the 10-year followup, Satisfactory ra nge of motion of the wrist and the forearm was maintained. There was no ins tability in the joint, and grip strength measured 65% of the opposite side. Postoperative magnetic resonance imaging showed survival of the whole graf t, including the subchondral portion. In addition to thorough revasculariza tion of the graft, appropriate soft tissue reconstruction using dynamic ten don transfer contributed to the success. When these requirements are fulfil led, the graft can provide a functional and durable result. Although this i s a single experience, the authors recommend wrist arthroplasty, rather tha n arthrodesis, in carefully selected patients.