Comparison of osteoarticular allograft reconstruction with and without the Sauvé-Kapandji procedure following tumour resection in distal radius.

Abstract

The purpose of this study was to compare the midterm functional and oncological outcomes of patients with distal radial tumours treated with en bloc tumour excision and osteoarticular allograft reconstruction with or without a Sauvé-Kapandji (S-K) procedure. All cases of osteoarticular allograft reconstruction with or without the S-K procedure following resection of distal radial tumours (giant-cell tumour in 13, desmoplastic fibroma in two, osteosarcoma in one and malignant fibrous histiocytoma in one) performed from 2000 to 2009 were evaluated by clinical and radiologic examinations; the complications, functional outcomes and Musculoskeletal Tumor Society (MSTS) score were recorded. Seventeen patients (seven with the S-K procedure and 10 without the S-K procedure) with an average age of 31.8 years formed the study population. The follow-up time averaged 84.7 months. All patients continued to be disease-free except one with a local relapse. The reconstructive complications included non-union of radio allograft in one, allograft fracture in five, rupture of tendon in two and degenerative joint disease in all cases. Patients with the S-K procedure had better range of rotation (P = 0.040), greater grip power (P = 0.028) and less degenerative changes (P = 0.014) than those without the S-K procedure. Patients with additional S-K procedure tended to have a higher MSTS score (P = 0.073). En bloc resection of tumour in the distal radius followed by reconstruction with an osteoarticular allograft results in satisfactory oncologic and functional outcomes. Addition of the S-K procedure could improve functional outcomes with regard to allograft reconstruction. Evidence Rating Scale for Therapeutic Studies: Level III.