[Low-cost reconstructive treatment after resection of distal radius giant cell tumor].

Acta ortopedica mexicana Pub Date : 2022-05-01
C M Quiñonez-Flores, C Arzate-Quintana, J L Carrasco-De la Fuente, C Torres-Castro
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Abstract

Introduction: giant cell tumor (GCT) is a benign intramedullary bone tumor that frequently arises at the ends of long bones. After the distal femur and proximal tibia, the distal radius is the third most affected site with particularly aggressive tumors. Our objective is the presentation of the clinical case of a patient diagnosed with distal radius GCT classified in grade III of Campanacci who received a treatment adjusted to her economic possibilities.

Case report: a 47-year-old female, without economic solvency and with some medical service. Treatment included block resection, reconstruction with distal fibula autograft, and radiocarpal fusion with blocked compression plate. Eighteen months later, the patient had good grip strength (80% on the healthy side) and had fine motor function in the hand. The wrist presented stability with pronation of 85o, supination of 80o, flexion-extension of 0o and a score of 6.7 in the DASH functional outcomes assessment questionnaire. His radiological evaluation five years after his surgery continued with no evidence of local recurrence and pulmonary involvement.

Conclusion: the result in this patient, together with the published data, indicate that the block tumor resection technique, plus distal fibula autograft and arthrodesis with blocked compression plate provide an optimal result of functionality for the grade III distal radial tumor at low cost.

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[桡骨远端巨细胞瘤切除术后的低成本重建治疗]。
巨细胞瘤(giant cell tumor, GCT)是一种良性骨髓内肿瘤,多发生于长骨末端。在股骨远端和胫骨近端之后,桡骨远端是第三个最易受肿瘤侵袭的部位。我们的目的是介绍一个临床病例的患者诊断为桡骨远端GCT分类为坎帕纳奇III级谁接受了治疗调整到她的经济能力。病例报告:47岁女性,无经济偿付能力,有一定医疗服务。治疗包括骨块切除、自体腓骨远端移植物重建和带骨块加压钢板的桡腕骨融合。18个月后,患者握力良好(健康侧80%),手部运动功能良好。腕关节稳定,旋前850度,旋后800度,屈伸1000度,DASH功能结果评估问卷得分6.7分。手术后5年的放射学评估没有发现局部复发和肺部受累的迹象。结论:该患者的结果和已发表的数据表明,闭塞性肿瘤切除技术加自体腓骨远端移植物和闭塞性加压钢板关节融合术为低成本的III级桡骨远端肿瘤提供了最佳的功能效果。
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