Ververidis Athanasios N, Drosos Georgios I, Tilkeridis Konstantinos E, Kazakos Konstantinos I
Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece.
J Orthop. 2015 Feb 21;12(Suppl 1):S125-9. doi: 10.1016/j.jor.2015.01.024. eCollection 2015 Oct.
Giant cell tumour is a frequent benign neoplasm. It is characterized by local aggressive behaviour and frequent recurrence. The most common localization is the distal femur followed by proximal tibia (40%). The distal radius is the next place (10%). The recurrence in the distal radius in primary cases is reported 10%, in recurrent cases is almost 30% and depends to the kind and the stage of the tumour at the time of treatment. Multiple options have been reported for treatment of Campanacci III giant-cell tumour (GCT) of the distal radius after resection. Actually the treatment of recurrence remains a real dilemma. Several reconstructive options (e.g. resection arthroplasty, prosthetic replacement, arthrodesis, ulnar translocation, centralization of the carpus over the remaining ulna, use of vascularized or nonvascularized fibular graft, with or without, arthrodesis, have been described up to date. We present a case of recurrence of GCT of distal radius after curettage, where we selected the centralization of the ulna into the carpus as a salvage procedure with satisfactory results. The procedure provides a valid option for the management of recurrent GCTs of distal radius offering excellent cosmetic and acceptable functional result.
骨巨细胞瘤是一种常见的良性肿瘤。其特点是具有局部侵袭性且复发频繁。最常见的发病部位是股骨远端，其次是胫骨近端（40%）。桡骨远端是下一个常见部位（10%）。据报道，原发性桡骨远端骨巨细胞瘤的复发率为10%，复发性病例的复发率近30%，且取决于治疗时肿瘤的类型和分期。对于桡骨远端Campanacci III级骨巨细胞瘤切除术后的治疗，已有多种方法被报道。实际上，复发的治疗仍然是一个真正的难题。迄今为止，已经描述了几种重建方法（例如切除关节成形术、假体置换、关节融合术、尺骨移位、腕骨在剩余尺骨上的中心化、使用带血管或不带血管的腓骨移植，有无关节融合术）。我们报告了一例刮除术后桡骨远端骨巨细胞瘤复发的病例，我们选择了尺骨中心化至腕骨作为挽救手术，结果令人满意。该手术为桡骨远端复发性骨巨细胞瘤的治疗提供了一种有效的选择，具有出色的美容效果和可接受的功能结果。
