Journal List > J Korean Soc Surg Hand > v.18(4) > 1106444

Lee, Chung, and Han: Several Considerations in Free Vascularized Fibular Head Grafting for Giant Cell Tumor of Distal Radius

Abstract

Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. The management of giant cell tumor involving subchondral bone of the distal radius has always been a difficult problem and whether preserving joint function should be considered. In these circumstances, wrist arthroplasty using free vascularized fibular head grafting can be considered as one of available options to preserve the wrist joint motion. However, the reports for final outcomes of wrist arthroplasty using vascularized fibular head have been variable and there have been several debates about its techniques. The purpose of this article is to discuss the several considerations in wrist arthroplasty using free vascularized fibular head graft for giant cell tumors of the distal radius.

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Fig. 1.
A 62-year-old man. (A) Preoperative X-ray. (B) Contralateral proximal fibular head based on anterior tibial artery was harvested. (B) The some articular cartilage of the ulnar side was preserved after wide excision of giant-cell tumor. Intraoperative findings show the internal fixation with multiple cortical screws. (D) Postoperative 11.5 years later, X-rays show good alignment and mild degenerative change of the fibulocarpal joint.
jkssh-18-189f1.tif
Fig. 2.
The articular surface of right distal radius shows volar tilting, but the articular surface of left proximal fibular head shows dorsal tilting.
jkssh-18-189f2.tif
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