WRIST ARTHRODESIS FOLLOWING RESECTION OF RECURRENT GIANT CELL TUMOR OF DISTAL END OF RADIUS: A CASE REPORT

• Venkatesh Mulimani,  
• Virendra Bhasme,  
• Rajesh B Naik,*  
• Sameer Shrivastava,  
• Gangadhar S

Abstract

The recurrence rate of giant cell tumor (GCT) of bone is 20%. GCT of bone is an aggressive and potentially malignant lesion, and variable clinical behaviour. The distal femur and proximal tibia are the most common sites, accounting for 50% of all GCT of bone, followed by the distal radius (10%).The prevalence of GCT peaks during the 3rd decade, with 80% of cases occurring between 20 and 50 years of age. Local recurrence and loss of joint function are still major problems following surgery The goals of treatment are to achieve satisfactory removal of the tumor, to decrease the chance of local recurrence, and to preserve as much wrist function as possible. Here we present a case of 32-year-old female patient presented with painful lump over right wrist joint since 2 months. Previously patient was surgically treated with intralesional curettage and illiac crest bone graft and bone cement for GCT of distal end of Radius 2 years back. Xray and Magnetic resonance imaging (MRI) showed a well-defined u expansile lytic soft tissue lesion which is homogenously enhanced involving medullary cavity with cortical erosion and extending into soft tissue plane. We performed wide resection of distal third radius and ulna using dorsal approach with radial strut graft and wrist arthrodesis. Functional outcome was evaluated using the modified Musculoskeletal Tumor Society scoring system. Grip strength was assessed using a dynamometer, and range of motion of the metacarpophalangeal joint was assessed using a goniometer.

Keywords

Giant cell tumor,Recurrence,Distal end of Radius,Wrist arthrodesis,Musculoskeletal Tumor Society scoring system