Wrist Arthrodesis and Osteoarticular Reconstruction in Giant Cell Tumor of the Distal Radius

Giuseppe Bianchi, Andrea Sambri, Eleonora Marini, Raimondo Piana, Domenico Andrea Campanacci, Davide Maria Donati

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: The aim of this multi-institutional retrospective study was to compare osteoarticular graft reconstruction (OA) and wrist arthrodesis (WA) after distal radius resection for giant cell tumor.

MATERIAL AND METHODS: Sixty-seven patients affected by giant cell tumor of the distal radius underwent resection and reconstruction with OA (47 patients) or WA (20 patients). The mean age was 40 years (range, 13-74 years). Grafts included fresh-frozen allograft or nonvascularized fibular autograft. Complications requiring surgical revision were recorded. Clinical outcome was assessed with the Musculoskeletal Tumour Society Score (MSTS) and Disabilities of the Arm, Shoulder, and Hand (DASH) score.

RESULTS: Fifteen patients developed a local recurrence after a median of 12 months (range, 6-137 months). Sixteen patients required revision surgery for complications. Of these, 10 were graft-related complications (7 in the OA group and 3 in the WA group). Among OA, 2 patients with painful instabilities and 4 with severe arthritis required conversion into WA after a mean of 26 months (range, 13-38 months) At a median follow-up of 105 months (range, 12-395 months), similar functional outcome (MSTS and DASH score) was observed between OA and WA.

CONCLUSIONS: Our results did not show any advantage of OA or WA over the other technique. A patient-by-patient decision should be taken both regarding the type of reconstruction (OA or WA) and the type of graft (allograft or autograft). The reconstructive choice should also consider the patient's functional expectations.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Original languageEnglish
Pages (from-to)882.e1-882.e6
Number of pages6
JournalJournal of Hand Surgery: European Volume
Volume45
Issue number9
Early online dateApr 17 2020
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Giant cell tumors
  • radius
  • arthrodesis
  • autografts
  • allografts

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