Sanesh Tuteja, Sachin Kale, Prasad Chaudhari, B Dhar Sanjay
Department of Orthopaedics, D.Y Patil University School of Medicine and Hospital, Navi Mumbai, India.
J Orthop Case Rep. 2016 Jul-Aug;6(3):16-18. doi: 10.13107/jocr.2250-0685.480.
Giant Cell Tumors commonly occur around the knee joint in the age group of 20-30 years. They are treated with intra-lesional curettage or local resection and limb reconstruction. Management of large bone defects after resection is a challenge and is of ten complicated with non-union of grafts, infection and delayed weight bearing.
A 37-year-old male presented with an aggressive recurrent giant cell tumor of the distal femur. He was and was diagnosed with a GCT of the left distal femur 2 years ago for which he was treated with an intralesional curettage and Poly methylmetacrylate implantation. A resection arthrodesis using a bilateral non-vascularised intramedullary fibular graft and a custom made intramedullary nail was performed. The follow-up radiographs showed union at graft-host junction and hypertrophy of the grafted fibula at 2 years post surgery.
Non-vascularised fibular graft is an effective alternative for resection arthrodesis with the advantages of a simpler and shorter surgical procedure and without the needs for a microsurgical setup.
骨巨细胞瘤常见于20至30岁年龄段人群的膝关节周围。治疗方法包括病灶内刮除术或局部切除术以及肢体重建。切除术后大的骨缺损的处理是一项挑战，常伴有移植骨不愈合、感染和负重延迟等并发症。
一名37岁男性，患有侵袭性复发性股骨远端骨巨细胞瘤。他两年前被诊断为左股骨远端骨巨细胞瘤，并接受了病灶内刮除术和聚甲基丙烯酸甲酯植入治疗。采用双侧非血管化髓内腓骨移植和定制髓内钉进行了切除关节固定术。术后2年的随访X线片显示移植骨与宿主骨交界处愈合，移植的腓骨肥大。
非血管化腓骨移植是切除关节固定术的一种有效替代方法，具有手术操作更简单、更短，且无需显微外科手术设备的优点。
