Nội dung chính của bài viết
Giant cell tumors (GCT) of the distal end of radius are relatively common tumors, representing approximately 5% of all primary bone tumors. It is the third most common location for GCT following distal femur and proximal tibia. In general, treatment includes thorough tumor excision, reconstruction of the defect, and wrist joint rehabilitation. The proximal fibular free flap is an ideal material for distal radius reconstruction after giant cell tumor excision. We present a case of a 57-year-old female, admitted to the hospital due to painful and limited proper wrist movement. Based on X-ray and Magnetic resonance imaging (MRI) images and histopathology findings, the patient was diagnosed with a stage 3 giant cell tumor of the distal radius. The patient underwent a one-step surgery of tumor excision and distal radius reconstruction by a vascularized proximal fibular free flap. 2 years follow-up post-surgery showed that the patient had no pain of the wrist, improved wrist joint function, no sign of recurrence, and good flap vitality and the knee joint remains normal. In conclusion, the surgery was successful with no further prolonged pain, improvement of the wrist joint function and overall improvement of the patient quality of life.
Chi tiết bài viết
Giant cell tumor, proximal fibular flap, distal radius defect
Tài liệu tham khảo
2. McGrath PJ. Giant-cell tumour of bone: an analysis of fifty-two cases. J Bone Joint Surg Br. 1972;54(2):216-229. 3. Goldenberg RR, Campbell CJ, Bonfiglio M. Giant-cell tumor of bone. An analysis of two hundred and eighteen cases. J Bone Joint Surg Am. 1970;52(4):619-664.
4. O’Donnell RJ, Springfield DS, Motwani HK. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg Am. 1994;76(12):1827-1833.
5. Sheth DS, Healey JH, Sobel M. Giant cell tumor of the distal radius. J Hand Surg; 1995;20(3):432-440.
6. Saleh R., Yurianto H, Pasallo P. Good functional outcome evaluation of free vascularized fibular head graft (FVFHG) as
treatment after resection of giant cell tumor (GCT) campanacci 3 at proximal humerus: A case report. Int J Surg Case Rep. 2019;61:254-258.
7. Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg. 1975;55(5):533-544.
8. Malizos KN, Zalavras CG, Soucacos PN. Free vascularized fibular grafts for reconstruction of skeletal defects. J Am Acad
Orthop Surg. 2004;12(5):360-369.
9. Taylor GI, Wilson KR, Rees MD. The anterior tibial vessels and their role in epiphyseal and diaphyseal transfer of the fibula:
experimental study and clinical applications. Br J Plast Surg. 1988;41(5):451-469.
10. Başarir K, Selek H, Yildiz Y. Nonvascularized fibular grafts in the reconstruction of bone defects in orthopedic oncology. Acta Orthop Traumatol Turc. 2005;39(4):300-306.
11. Krieg AH, Hefti F. Reconstruction with non-vascularised fibular grafts after resection of bone tumours. J Bone Joint Surg Br. 2007;89(2):215-221.
12. Enneking WF, Eady JL, Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J
Bone Joint Surg Am. 1980;62(7):1039-1058.
13. Innocenti M, Delcroix L, Manfrini M. Vascularized proximal fibular epiphyseal transfer for distal radial reconstruction. J Bone Joint Surg Am. 2004;86(7):1504-1511.
14. Mack GR, Lichtman DM, MacDonald RI. Fibular autografts for distal defects of the radius. J Hand Surg. 1979;4(6):576-583.