The results of surgical treatment of giant cell tumors of the distal radius
were reviewed in 12 patients between 1982 and 1995. All 12 patients had Gr
ade III lesions. Six of the 12 patients were treated using intralesional cu
rettage with local excision, and the other six patients underwent en bloc r
esection with total condyle (four of the six by osteoarticular allograft, a
nd the other two by fibular autograft) reconstruction with the aim of prese
rving the functional joint. There were no early or late complications such
as infection, graft fracture, implant failure, or nonunion. No local tumor
recurrence was seen in either group during the average followup of 6 years
(range, 3-16 years). The best functional result was seen in the patients tr
eated with intralesional curettage. The functional result of the resection
group was good, achieving an average of 69% (range, 56%-83%) of their range
of motion and 70% (range, 63%-77%) of their grip strength on the contralat
eral side. Intralesional excision should not he excluded as a possible trea
tment of Grade III lesions, although en bloc resection was used more common
ly for these lesions because of tumor surgery reasons. Grade III lesions we
re treated with curettage when the tumor did not invade the wrist, destroy
more than 50% of the cortex, or break through the cortex with an extraosseo
us mass in more than one plane. Reconstruction with osteoarticular allograf
t after en bloc resection is recommended in this non-weightbearing joint wh
en there is contraindication for curettage of the lesion.