Treatment of giant cell tumor of distal radius with limited soft tissue invasion: Curettage and cementing versus wide excision

• Published in: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association Vol. 23; no. 1; pp. 174 - 179
• Main Authors: Mozaffarian, Kamran, Modjallal, Mehra, Vosoughi, Amir Reza
• Format: Journal Article
• Language: English
• Published: Japan Elsevier B.V 01.01.2018
• Subjects: Adult; Arthroplasty - methods; Bone Cements - therapeutic use; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - pathology; Bone Neoplasms - therapy; Cementation - methods; Cohort Studies; Combined Modality Therapy; Curettage - methods; Female; Follow-Up Studies; Giant Cell Tumor of Bone - diagnostic imaging; Giant Cell Tumor of Bone - pathology; Giant Cell Tumor of Bone - therapy; Humans; Male; Neoplasm Invasiveness - pathology; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; Prospective Studies; Radius - diagnostic imaging; Radius - pathology; Risk Assessment; Treatment Outcome; Young Adult
• ISSN: 0949-2658; 1436-2023; 1436-2023
• DOI: 10.1016/j.jos.2017.10.001

Intralesional curettage and adjuvant versus wide en bloc excision (WEE) as the best treatment method of giant cell tumor (GCT) of distal radius with limited soft tissue extension is a controversial topic. Prospectively, 13 patients who had GCT of distal radius with perforation of either volar or dorsal cortex of the bone and soft tissue extension which was confined to one plane were enrolled in the study. Six patients treated with ICC and seven cases cured by WEE technique and proximal fibular arthroplasty. The results were evaluated based on recurrence, range of motion of the wrist joint, rotation of the forearm, grip and pinch power. The mean age of the patients treated with ICC and WEE techniques were 32.7 (range: 23–43) and 34.5 (range: 28–44), respectively. Mean follow-up period was 72 months (range: 28–148). Local recurrence was seen in 4 of 6 patients (66.7%) underwent ICC technique but in none of the 7 subjects treated with WEE technique (P value = 0.021). The overall range of flexion/extension and supination/pronation in the WEE group were 83% and 92% of the ICC group, respectively. Both of pinch and grip power were 14% less in the WEE group compared to the ICC group. In GCT lesion of distal radius even with limited soft tissue extension, WEE and proximal fibular arthroplasty may be a more reasonable suggestion when the patient seeks a one-shot surgery.