IOACON 2025 PRESENTATION ON TUMOR DISTAL RADIUS RX BY EXCISION & AUTOLOGUS FIBULA RECONSTRUCTION

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introduction
The distal radius is the third most common site for giant cell tumors (GCT) of long bones, with a 1% metastasis rate, primarily to the lungs. Reconstruction options include vascularized and nonvascularized fibular grafts, ulnar centralization or translocation, and endoprosthetic replacement. This study evaluates the outcomes of nine cases treated with en bloc tumor excision and nonvascularized fibular graft reconstruction.
Materials and Methods:
Nine patients (mean age: 33.15 years; range: 21–53 years) with distal radius GCT were included. Six had Campanacci Grade III tumors, and three had Grade II. All underwent wide excision and ipsilateral nonvascularized fibular grafting, fixed with a small fragment plate. Autogenous iliac crest grafting was performed at the fibuloradial junction. Radiocarpal fusion was conducted in five cases to prevent wrist subluxation and enhance graft union.

Results:
Among nine patients (six males, three females), mean follow-up was 2.3 years (range: 1.5–8 years). Fibuloradial junction union averaged 33 weeks (14–69 weeks), with fibulocarpal fusion achieving earlier union (18 weeks vs. 24 weeks). Mean grip strength was 71% (42–86%), and range of motion totaled 162°. Wrist fusion cases had 30% higher grip strength than arthroplasty cases. The mean MSTS score was 91.38%, with four excellent, three good, and two satisfactory results. No graft-related complications, deep infections, or tumor recurrences were observed.

Conclusion:
En bloc excision with nonvascularized fibular graft is a reliable treatment for distal radius GCT, offering favorable functional outcomes and minimizing recurrence risks. Fibulocarpal fusion improves stability and function in unstable cases











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Categoria
Oncology
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