Fibulo-scapho-lunate arthrodesis after resection of the distal radius for giant-cell tumor of the bone.

Abstract

Giant-cell tumors of the distal radius are rare. They have a high-risk of local recurrence and a risk of pulmonary metastasis. Curettage alone or combined with adjunctive agents is often associated with local recurrence. Three patients with giant-cell tumor of the distal radius are presented. All patients showed Campanacci grade 3 lesions. All patients underwent complete distal radius resection and reconstruction with a vascularized fibular graft distally fused with the scaphoid and the lunate, allowing midcarpal motion. The follow-up period ranged from 6 to 60 months. For all three patients, emotional acceptance was excellent. The postoperative motion of the wrist was good, with a range of motion of 30-0-30°, 40-0-0°, and 30-0-10° (extension-flexion). There was neither tumor recurrence nor pulmonary metastasis. Fibulo-scapho-lunate fusion is an elegant method of distal radius reconstruction with good functional outcome and low risk of pulmonary metastasis.