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

J Korean Soc Surg Hand. 2013 Dec;18(4):189-195. Korean.
Published online December 27, 2013.  https://doi.org/10.12790/jkssh.2013.18.4.189
Copyright © 2013. The Korean Society for Surgery of the Hand
Several Considerations in Free Vascularized Fibular Head Grafting for Giant Cell Tumor of Distal Radius
Jae Hoon Lee,1 Duke Whan Chung,2 and Chung Soo Han2
1Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
2Department of Orthopaedic Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.

Correspondence to: Jae-Hoon Lee. Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, Korea. TEL: +82-2-440-6153, FAX: +82-2-440-7498, Email: ljhos69@naver.com
Received November 23, 2013; Revised December 03, 2013; Accepted December 05, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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 fubular head graft for giant cell tumors of the distal radius.

Keywords: Giant cell tumor; Distal radius; Wrist arthroplasty; Vascularized fibular head graft

Figures


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.
Click for larger image


Fig. 2
The articular surface of right distal radius shows volar tilting, but the articular surface of left proximal fibular head shows dorsal tilting.
Click for larger image

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